Organization Active NPI

Kidney Institute of Clearwater, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Clearwater, FL
National Provider Identifier
1427073097
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
KIDNEY INSTITUTE OF CLEARWATER, LLC
Practice address
617 Lakeview Rd
Suite C
Clearwater, FL 33756-3338
Phone
(727) 441-2913
Fax
(727) 441-4291
NPI assigned
Jul 13, 2006
Last updated
Nov 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
June A. Clark
Title
Vice President
Phone
(727) 733-2040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

617 Lakeview Rd
Suite C
Clearwater, FL 33756-3338

Mailing address

1964 Bayshore Blvd
Suite C
Dunedin, FL 34698-2576
Phone (727) 733-2040

National Provider Directory

National Provider Directory

Locations

1964 Bayshore Blvd
Ste C
Dunedin, FL 34698
Phone (727) 733-2040

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1427073097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 BAYSHORE BLVD",
            "address_2": "SUITE C",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346982576",
            "telephone_number": "727-733-2040",
            "fax_number": "727-733-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 LAKEVIEW RD",
            "address_2": "SUITE C",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563338",
            "telephone_number": "727-441-2913",
            "fax_number": "727-441-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY INSTITUTE OF CLEARWATER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JUNE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "727-733-2040"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.