Kerricher Dialysis, LLC

Primary specialty

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

Legal business name

KERRICHER DIALYSIS, LLC

Practice address

2400 Lands End Blvd
Ste 131
Fort Worth, TX 76116-2170

Phone

(817) 570-0916

Fax

(817) 377-0279

NPI assigned

Sep 2, 2014

Organization subpart

No

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

Authorized official

Name

John Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cowtown West Dialysis Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Renal Treatment Centers-Southeast, LP.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Donna, TX
  • NPI 1902353543

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588204800000",
    "number": "1184024770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-341-6764",
            "fax_number": "833-781-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LANDS END BLVD",
            "address_2": "STE 131",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761162170",
            "telephone_number": "817-570-0916",
            "fax_number": "817-377-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRICHER DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-02",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "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": "366415301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cowtown West Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cowtown West Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren McCarthy Kern, MS, RD, LD, IFNCP
• Jean L. Kernal, CNS-AD
• Jonathan Kerr, MD
• Kelsey Kerr, MS, LPC-ASSOCIATE
• Robert Alan Kerr, P.T.
• Cassidy Rae Keshvani, PA-C
• Ruth Marie Kested, PA
• Oliver Lee Kesterson III, M.D.
• Tracey Murrell Kesterson, RN
• Ashley Ketchum, LCSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, 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 Apr 30, 2020; 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.