Usrc West Fort Worth Dialysis LLC

Primary specialty

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

Legal business name

USRC WEST FORT WORTH DIALYSIS LLC

Doing business as

U.S. Renal Care West Fort Worth Dialysis
US Renal Care Tarrant Dialysis West Fort Worth

Practice address

1704 S Cherry LN
Suite 200
White Settlement, TX 76108-3629

Phone

(817) 367-0822

Fax

(817) 367-1520

NPI assigned

Dec 27, 2007

Last updated

May 25, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

US RENAL CARE INCAs reported in NPPES

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

Authorized official

Name

Mr. Thomas L Weinberg

Title

Sr VP/General Counsel

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 2

• U.S. Renal Care West Fort Worth Dialysis Doing business as
• US Renal Care Tarrant Dialysis West Fort Worth Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Usrc West Fort WorthCCN 672637

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Jan 14, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

12

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

Affiliated clinicians 2

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

• Patrick C Nef, M.D

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1194901330

  Dialysis facility

  Care Compare affiliation Name & address match
• Balamurugan Ponniah Sankarapandian, M.D.

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1881816437

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1407030364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251549",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251500",
            "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": "1704 S CHERRY LN",
            "address_2": "SUITE 200",
            "city": "WHITE SETTLEMENT",
            "state": "TX",
            "postal_code": "761083629",
            "telephone_number": "817-367-0822",
            "fax_number": "817-367-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC WEST FORT WORTH DIALYSIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE INC",
        "enumeration_date": "2007-12-27",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR VP/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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care West Fort Worth Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "US Renal Care Tarrant Dialysis West Fort Worth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "US Renal Care Tarrant Dialysis West Fort Worth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in White Settlement, TX
• Providers in White Settlement, 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 May 25, 2022; 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.