Sanderling Renal Services of Holdenville

Primary specialty

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

Legal business name

SANDERLING RENAL SERVICES OF HOLDENVILLE

Doing business as

Sanderling Dialysis Center of Holdenville

Practice address

102 Crestview St
Holdenville, OK 74848-2844

Phone

(615) 467-0140

NPI assigned

Aug 31, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jereome S Tannenbaum, M.D.,PH.D.

Title

Administrator

Phone

(615) 467-0140

Specialties & licenses 1

Addresses

Other names 1

• Sanderling Dialysis Center of Holdenville Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Listed as

Sanderling Dialysis Center of HoldenvilleCCN 372589

Overall star rating

1.0 of 5

Ownership

Profit

Certified

May 24, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Other

Dialysis stations

16

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 1

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.

• Jerome Seymour Tannenbaum, M.D., PH.D.

  • Nephrology Physician
  • Nashville, TN
  • NPI 1346485638
  NPD (past)

Affiliated clinicians 2

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

• Venkata Rama Gopala Sriharsha Damera, MBBS

  • Nephrology Physician
  • Shawnee, OK
  • NPI 1861646358

  Dialysis facility

  Care Compare affiliation Name & address match
• Chris M Sholer, MD

  • Nephrology Physician
  • Oklahoma City, OK
  • NPI 1326047226

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1124377460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198813",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372198813",
            "telephone_number": "615-467-0140",
            "fax_number": "615-259-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CRESTVIEW ST",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748482844",
            "telephone_number": "615-467-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDERLING RENAL SERVICES OF HOLDENVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-31",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "TANNENBAUM",
        "authorized_official_first_name": "JEREOME",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "615-467-0140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,PH.D."
    },
    "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": "Sanderling Dialysis Center of Holdenville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jimmie Ray Rodgers
• Karis Ashley Rodriguez, APRN CNP
• Mark Jeremy Rosengren, D.O.
• Rural Area Counseling Center
• Jennifer Russell
• Fred Steven Sanders, DO
• Erika Glyn Seeley
• Don A Shields, DC
• Joanna Sullivan
• Therapy Care Outpatient PC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Holdenville, OK
• Providers in Holdenville, OK by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.