U S Renal Care of Northeast Arkansas LLC

Primary specialty

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

Legal business name

U S RENAL CARE OF NORTHEAST ARKANSAS LLC

Doing business as

Paragould - US Renal Care

Practice address

901 W Kingshighway
Paragould, AR 72450-5943

Phone

(870) 215-0187

Fax

(870) 215-5320

NPI assigned

Dec 30, 2005

Last updated

Oct 25, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

US RENAL CARE INC.As reported in NPPES

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

Authorized official

Name

Mr. Thomas Weinberg

Title

Vice President - General Counsel

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Paragould - US Renal Care Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Listed as

Usrc ParagouldCCN 042562

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Mar 9, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

13

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

US Renal Care Inc

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Mvny Partners VI, LLC

  dba U.S. Renal Care Hamilton Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hamilton, NY
  • NPI 1740923994

  Member Of

  NPD member

Locations

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mohammed Alhajji, M.D

  • Nephrology Physician
  • Jonesboro, AR
  • NPI 1962729970

  Dialysis facility

  Care Compare affiliation Name & address match
• Clinton Brough Edwards, MD

  • Nephrology Physician
  • Jonesboro, AR
  • NPI 1386611598

  Dialysis facility

  Care Compare affiliation Name & address match
• James Maxwell, MD

  • Nephrology Physician
  • Jonesboro, AR
  • NPI 1689714024

  Dialysis facility

  Care Compare affiliation Name & address match
• Adam Woodruff, MD

  • Nephrology Physician
  • Jonesboro, AR
  • NPI 1538383799

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1295712131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19119",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036601",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505943",
            "telephone_number": "870-215-0187",
            "fax_number": "870-215-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U S RENAL CARE OF NORTHEAST ARKANSAS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE INC.",
        "enumeration_date": "2005-12-30",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VICE PRESIDENT - GENERAL COUNSEL",
        "authorized_official_telephone_number": "214-736-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142641134",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "12562",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paragould - US Renal Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wrana Tull
• Jodi Anne Turano, D.O.
• Robert Corey Turley
• Gracie Turner
• Michael Wayne Turner, LPC
• Natalie Denise Underwood, PHARM D
• Sara Diane Underwood, APRN
• Siera Vail
• Humari Van Greunen
• Savannah Van Slyke

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Paragould, AR
• Providers in Paragould, AR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.