NPIMap

Organization Active NPI

San Antonio Kidney Disease Center Physicians Group, P.L.L.C.

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1467707240
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.
Practice address
2902 Goliad Rd
Suite 103
San Antonio, TX 78223-3971
Phone
(210) 337-4911
Fax
(210) 337-7749
NPI assigned
Jul 18, 2012
Last updated
Apr 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Authorized official

Name
Clay Roby
Title
Executive Director
Phone
(210) 481-7453

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

2902 Goliad Rd
Suite 103
San Antonio, TX 78223-3971

Mailing address

7142 San Pedro Ave
Suite 120
San Antonio, TX 78216-6256
Phone (210) 481-7453

National Provider Directory

National Provider Directory
Tax ID family
San Antonio Kidney Disease Center Physicians Group PLLC32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

2902 Goliad Rd
Ste 103
San Antonio, TX 78223
Phone (210) 337-4911

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1467707240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7142 SAN PEDRO AVE",
            "address_2": "SUITE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166256",
            "telephone_number": "210-481-7453",
            "fax_number": "210-481-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 GOLIAD RD",
            "address_2": "SUITE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233971",
            "telephone_number": "210-337-4911",
            "fax_number": "210-337-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2014-04-10",
        "status": "A",
        "authorized_official_last_name": "ROBY",
        "authorized_official_first_name": "CLAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "210-481-7453"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.