Wellbound of Vallejo LLC

Primary specialty

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

Legal business name

WELLBOUND OF VALLEJO LLC

Practice address

480 Redwood St
Suite 40
Vallejo, CA 94590-2958

Phone

(707) 556-3070

Fax

(707) 556-3075

NPI assigned

Jun 20, 2006

Organization subpart

Yes

Parent organization

WELLBOUND LLCAs reported in NPPES

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

Authorized official

Name

Thomas L Weinberg

Title

President/Coo

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WellBound of Vallejo Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

SHC WB VallejoCCN 552560

Ownership

Non-profit

Certified

Oct 18, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

4

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

Wellbound LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Satellite Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jamestown, CA
  • NPI 1649241720

  Member Of

  NPD member

Affiliated clinicians 1

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

• Claudia I Iota-Herbei

  • Nephrology Physician
  • Berkeley, CA
  • NPI 1548367113

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1487699567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SANTANA ROW",
            "address_2": "SUITE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282423",
            "telephone_number": "707-556-3070",
            "fax_number": "650-625-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 REDWOOD ST",
            "address_2": "SUITE 40",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902958",
            "telephone_number": "707-556-3070",
            "fax_number": "707-556-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLBOUND OF VALLEJO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLBOUND LLC",
        "enumeration_date": "2006-06-20",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC52560F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellBound of Vallejo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellBound of Vallejo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul David Weiner
• Lanford M. Weingrod, MD
• Robert Brandon Weis
• Keith Welch
• Joan Evelyn Weldon
• Wellness Home Health Agency LLC
• Wellness Hospice LLC
• Robin Wempe, PA
• Jazelle David Wenceslao
• Wendy a. Wigmore

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Vallejo, CA
• Providers in Vallejo, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.