Interwell Health Medical Practice of Kansas LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

INTERWELL HEALTH MEDICAL PRACTICE OF KANSAS LLC

Practice address

68 Harrison Ave Ste 39516
Boston, MA 02111

Phone

(833) 664-8244

NPI assigned

Oct 24, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Julie Dominguez, MDNPI 1871760223

Title

President

Phone

(833) 644-8244

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

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

• Julie Rankin Dominguez, MD

  • Nephrology Physician
  • San Diego, CA
  • NPI 1871760223

  TX

  Medicare reassignment NPD Authorized official
• Bianca Blanco, NP

  • Family Nurse Practitioner
  • Foster City, CA
  • NPI 1649631078
  NPD
• Kathleen Guerrera

  • Family Nurse Practitioner
  • Fairfield, CT
  • NPI 1326597105
  NPD
• Sara Elaine Vote, APRN, FNP-C

  • Family Nurse Practitioner
  • Conway, AR
  • NPI 1871938019
  NPD

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1508687229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 HARRISON AVE STE 605 PMB 39516",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "833-664-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HARRISON AVE STE 39516",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "833-664-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERWELL HEALTH MEDICAL PRACTICE OF KANSAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "833-644-8244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intriguing Hair LLC
• Sunny Suresh Intwala, M.D.
• Ioannis P. Glavas, M.D., PLLC
• Marianna Da Fonseca Ioannou

• Nephrology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Nephrology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.