Aqua Dialysis Frank Avenue, LLC

Primary specialty

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

Legal business name

AQUA DIALYSIS FRANK AVENUE, LLC

Practice address

1520 W Frank Ave
Lufkin, TX 75904-3314

Phone

(936) 238-3583

NPI assigned

Oct 23, 2020

Last updated

Sep 10, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

AQUA DIALYSIS LLPAs reported in NPPES

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

Authorized official

Name

Alicia Carter

Title

Revenue Cycle Director

Phone

(682) 429-4508

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144829748. Details of each certification follow.

• CCN 672688 End-stage renal disease facility · Active · Name & address match · Details

End-stage renal disease facility certification: CCN 672688

Legal name

AQUA DIALYSIS FRANK AVENUE LLC

Certification status

Active

Provider type (POS)

End-stage renal disease facility

Participating since

May 1, 2011

Last certification

Jan 30, 2019

Ownership / control type

For Profit

Multi-facility organization

SANKAR NEPHROLOGY GROUP

Most recent change of ownership

Mar 1, 2023

Facility address

1520 W Frank Avenue
Lufkin, TX 75904

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.

• Namrata Sharma Goel, M.D.

  • Nephrology Physician
  • Houston, TX
  • NPI 1497862247
  NPD (past)

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1144829748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 SOUTHRIDGE CT STE 102",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760534390",
            "telephone_number": "682-429-4508",
            "fax_number": "346-214-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 W FRANK AVE",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043314",
            "telephone_number": "936-238-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQUA DIALYSIS FRANK AVENUE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AQUA DIALYSIS LLP",
        "enumeration_date": "2020-10-23",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "682-429-4508"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Warren Antee, D.D.S.
• Anthony P Noreiga DPM PA
• Theresa Leigh Anthony, LCDC
• Ifeoma Gloria Anugwom, PHARMD
• Apl Med PLLC
• Aqua Dialysis Lufkin LLC
• Argosy Mental Health Services P a
• Sheri Hoyler Arndt, PHARMD
• Michael Laverne Arnold, MD FACOG
• Sushma Arramraju, M.D

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Lufkin, TX
• Providers in Lufkin, 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 Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.