Usrc Keller LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

USRC KELLER LLC

Practice address

4420 Heritage Trace Pkwy
Suite 312
Fort Worth, TX 76244-8904

Phone

(817) 993-6516

Fax

(817) 562-4467

NPI assigned

May 22, 2013

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas L. Weinberg

Title

Vice President

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 2

• U.S. Renal Care Keller Dialysis Doing business as
• U.S. Renal Care Tarrant Dialysis Keller Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Usrc KellerCCN 672743

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Sep 23, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

12

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

US Renal Care Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• U.S. Renal Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Plano, TX
  • NPI 1588581870
  NPPES parent name

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Nishant B Jalandhara, MD

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1932116902

  Dialysis facility

  Care Compare affiliation Name & address match
• Imran Adam Memon, MD

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1952582157

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1073959631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844631",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844631",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 HERITAGE TRACE PKWY",
            "address_2": "SUITE 312",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448904",
            "telephone_number": "817-993-6516",
            "fax_number": "817-562-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC KELLER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2013-05-22",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Keller Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "U.S. Renal Care Tarrant Dialysis Keller",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "U.S. Renal Care Tarrant Dialysis Keller",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.