Churchill Dialysis LLC

Primary specialty

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

Legal business name

CHURCHILL DIALYSIS LLC

Practice address

894 FM 3168
Raymondville, TX 78580-4519

Phone

(956) 389-9084

Fax

(956) 689-1951

NPI assigned

Jan 4, 2011

Organization subpart

No

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

Authorized official

Name

Samuel T Wey

Title

VP Licensure&Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Valley Baptist Raymondville Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Churchill Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Harlingen, TX
  • NPI 1659675783

  7214118496

  Same PAC ID

Tax ID family

Churchill Dialysis LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Churchill Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Harlingen, TX
  • NPI 1659675783
  NPD tax ID

Member of 3

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

• Bainbridge Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Worth, TX
  • NPI 1699041152

  Member Of

  NPD member
• Renal Treatment Centers-Southeast, LP.

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

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1265736300",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 FM 3168",
            "city": "RAYMONDVILLE",
            "state": "TX",
            "postal_code": "785804519",
            "telephone_number": "956-389-9084",
            "fax_number": "956-689-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCHILL DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE&CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "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": "282733901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Baptist Raymondville Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Baptist Raymondville Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roxanne Marie Cantu, SLP-A
• Kristen Marie Carranco, MSN, APRN, FNP-C
• Edgar Ricardo Carrillo, MPAS, PA-C
• Reynaldo Chavez Jr., PTA
• Children First Pediatric Rehabilitation, LLP
• Raquel Closner, M.S., CCC-SLP
• Kimberly Anne Collins, PA
• Compass Connections
• CVS Pharmacy Inc
• Vanessa Noette Delarosa, PT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Raymondville, TX
• Providers in Raymondville, 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 Jul 24, 2024; 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.