Kidney Kare of Jacksonville FL, Inc.

Primary specialty

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

Legal business name

KIDNEY KARE OF JACKSONVILLE FL, INC.

Practice address

4168 Southpoint Pkwy
Jacksonville, FL 32216-0966

Phone

(954) 764-7695

Fax

(954) 764-7697

NPI assigned

Apr 11, 2012

Last updated

Apr 11, 2012By 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

Wendy Woods

Title

Owner

Phone

(954) 764-7695

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Kidney Kare of Jacksonville, IncCCN 682547

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Feb 12, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

8

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rania Abdel-Rahman, M.D.

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1013059211
  NPD (past)
• Adey A a Hasan, MD

  • Nephrology Physician
  • St Augustine, FL
  • NPI 1043516511
  NPD (past)

Affiliated clinicians 1

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

• Rania Abdel-Rahman, M.D.

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1013059211

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1114284494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 E DANIA BEACH BLVD",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330043028",
            "telephone_number": "954-764-7695",
            "fax_number": "954-764-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4168 SOUTHPOINT PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160966",
            "telephone_number": "954-764-7695",
            "fax_number": "954-764-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY KARE OF JACKSONVILLE FL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-764-7695"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura E Kidder, APRN
• Rachel Kidder, RN
• Cynthia Kiddey, APRN
• Kidney Clinic of Jacksonville, LLC
• Kidney Clinic of North Florida PLLC
• Kids and Families Medical Clinic LLC
• Kids First Dentistry,Inc
• Victor Kiebalo, MD
• John Michael Kiel, DO
• Katrina Kielbowicz, LMHC,LMFT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.