Organization Active NPI

Texarkana Kidney Disease & Hypertension Center, Inc.

  • Specialist
  • Texarkana, AR
National Provider Identifier
1508067331
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TEXARKANA KIDNEY DISEASE & HYPERTENSION CENTER, INC.
Practice address
422 Beech St
Texarkana, AR 71854-5310
Phone
(870) 773-1111
Fax
(870) 772-7692
NPI assigned
May 30, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mike Blankenship, MD
Title
President
Phone
(870) 773-1111

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0715168Texarkana Kidney Disease422 Beech Street, Texarkana, AR 71854Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hope Dialysis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2400 Saint Michael Dr
Ste 2
Texarkana, TX 75503

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

NPPES NPI Registry

Primary practice location

422 Beech St
Texarkana, AR 71854-5310

Mailing address

422 Beech St
Texarkana, AR 71854-5310
Phone (870) 773-1111

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 20, 2008.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1508067331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 BEECH ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718545310",
            "telephone_number": "870-773-1111",
            "fax_number": "870-772-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 BEECH ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718545310",
            "telephone_number": "870-773-1111",
            "fax_number": "870-772-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXARKANA KIDNEY DISEASE & HYPERTENSION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-773-1111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.