Isd Corpus Christi LLC

Primary specialty

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

License

008662 Issued in TX

Legal business name

ISD CORPUS CHRISTI LLC

Doing business as

Greenwood Holly Renal Center

Practice address

1533 Holly Rd
Corpus Christi, TX 78417-2010

Phone

(361) 850-7300

Fax

(361) 850-7305

NPI assigned

Dec 14, 2007

Last updated

Feb 18, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Greenwood Holly Renal Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita Greenwood Holly Renal CenterCCN 672630

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Mar 3, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

24

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

CLIA laboratory certificates

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Dva Healthcare Renal Care Inc

  dba Amelia Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Amelia Court House, VA
  • NPI 1861456113

  Member Of

  NPD member
• Isd Renal Inc

  dba Renal Care of Carthage

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Carthage, MS
  • NPI 1912952110

  Member Of

  NPD member
• Isd Renal, Inc.

  dba Navarre Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Navarre, OH
  • NPI 1134615651

  Member Of

  NPD member

Affiliated clinicians 4

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

• Shah Faizul Islam, M.D.

  • Nephrology Physician
  • Corpus Christi, TX
  • NPI 1841293727

  Dialysis facility

  Care Compare affiliation Name & address match
• William Lee Shaffer, M.D.

  • Nephrology Physician
  • Corpus Christi, TX
  • NPI 1972506913

  Dialysis facility

  Care Compare affiliation Name & address match
• Prabhat Singh, M.D.

  • Nephrology Physician
  • Corpus Christi, TX
  • NPI 1780972133

  Dialysis facility

  Care Compare affiliation Name & address match
• Fariba Zarinetchi, M.D.

  • Nephrology Physician
  • Corpus Christi, TX
  • NPI 1518960491

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1093998940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 HOLLY RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784172010",
            "telephone_number": "361-850-7300",
            "fax_number": "361-850-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD CORPUS CHRISTI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "008662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2117814-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenwood Holly Renal Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greenwood Holly Renal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elmer Scot Ireton, M.D.
• Eliana Irigoyen
• Sheila Irving, PTA
• Eileen Michelle Isaacs, LMSW
• Khyler Isaacs
• Isd Renal Inc (Corpus Christi Dialysis)
• Isd Renal Inc (Coastal Dialysis)
• Isd Renal Inc (Morgan Avenue Dialysis)
• Restydale Rodriguez Isip, FNP
• Shah Faizul Islam, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Corpus Christi, TX
• Providers in Corpus Christi, 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 Feb 18, 2025; 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.