Organization Active NPI

Kidney Care Institute PLLC

  • Nephrology Physician
  • Conroe, TX
National Provider Identifier
1164098778
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
KIDNEY CARE INSTITUTE PLLC
Practice address
2400 Farm to Market Rd 1488 #400
Conroe, TX 77384
Phone
(281) 206-7880
NPI assigned
Jun 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

Name
Sunitha Mogalla
Title
Supervisor
Phone
(347) 920-9281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

2400 Farm to Market Rd 1488 #400
Conroe, TX 77384

Mailing address

7 Archer Oak PL
Spring, TX 77382-2583
Phone (347) 920-9281

Other practice location 1

25312 Interstate 45 N
Spring, TX 77386-1449
Phone (832) 410-8389

Other practice location 2

2400 Fm 1488 Rd Ste 400
Conroe, TX 77384-4958
Phone (832) 410-8389

Other names 1

  • Kidney Care Institute PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210728001550 TX Part B Supplier - Clinic/Group Practice 7315340361 Receives reassigned benefits from 1 practitioner
Practice locations: Spring, TX

National Provider Directory

National Provider Directory

Locations

2400 FM 1488 Rd
Ste 400
Conroe, TX 77384
Phone (832) 410-8389

6700 Woodlands Pkwy
Ste 230289
Spring, TX 77382

25510 Interstate 45 N
#101
Spring, TX 77386
Phone (832) 410-8389

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1164098778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ARCHER OAK PL",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773822583",
            "telephone_number": "347-920-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 FARM TO MARKET RD 1488 #400",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "77384",
            "telephone_number": "281-206-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25312 Interstate 45 N",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773861449",
            "country_code": "US",
            "telephone_number": "832-410-8389",
            "fax_number": "832-410-4925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Fm 1488 Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773844958",
            "country_code": "US",
            "telephone_number": "832-410-8389",
            "fax_number": "832-410-4925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIDNEY CARE INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "MOGALLA",
        "authorized_official_first_name": "SUNITHA",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "347-920-9281"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kidney Care Institute PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.