Kidney Institute Center of Excellence, LLC

Primary specialty

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

Legal business name

KIDNEY INSTITUTE CENTER OF EXCELLENCE, LLC

Practice address

601 N 99TH St
Suite 100
Wauwatosa, WI 53226-4339

Phone

(414) 755-6300

NPI assigned

Mar 7, 2006

Last updated

May 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. June A. Clark

Title

Business Manager

Phone

(727) 733-2040

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1336116482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 BAYSHORE BLVD",
            "address_2": "STE C",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346982576",
            "telephone_number": "727-733-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 99TH ST",
            "address_2": "SUITE 100",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264339",
            "telephone_number": "414-755-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY INSTITUTE CENTER OF EXCELLENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JUNE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "727-733-2040",
        "authorized_official_name_prefix": "Mrs."
    },
    "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": "42061900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sardar Khan, MD
• Nazakat Kharazi, APNP
• Abdul Mateen Khazi, MD
• Whitney Kibler
• Deborah Kick, MASSAGE THERAPIST
• Michael Richard Kiel, LPC-IT
• Ashlea Evelyn Kielar, LPC-IT
• Krystina L Kienast, FNP-BC
• Simmone Renee Kilgore, MS, LPC
• Andrew C Kim, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.