Namg Home Dialysis LLC

Primary specialty

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

Legal business name

NAMG HOME DIALYSIS LLC

Doing business as

Magnolia West At Home

Practice address

3660 Park Sierra Dr
Ste 103
Riverside, CA 92505-3081

Phone

(951) 373-4004

Fax

(951) 373-4005

NPI assigned

Jun 28, 2007

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Senior L&C Administrator

Phone

(615) 341-6789

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Magnolia West At Home Doing business as

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1144427741",
    "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",
            "telephone_number": "615-341-5895",
            "fax_number": "866-890-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 PARK SIERRA DR",
            "address_2": "STE 103",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053081",
            "telephone_number": "951-373-4004",
            "fax_number": "951-373-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAMG HOME DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR L&C ADMINISTRATOR",
        "authorized_official_telephone_number": "615-341-6789"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144427741",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia West At Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Nam
• Jerry I Nam, MD
• Barbara Milbert Namayanja
• Amanda Catherine Nambar
• Namg Home Dialysis LLC
• Namg Riverside ASC LLC
• Chandani Nanavati, O.D.
• Shonit Nandakumar, MD
• Priscilla Doreen Nanez
• Stephanie Nanneman

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Riverside, CA
• Providers in Riverside, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.