NPIMap

Organization Active NPI

Isd Kansas City LLC

Doing business as Westport Renal Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Kansas City, MO
National Provider Identifier
1518142710
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ISD KANSAS CITY LLC
Doing business as
Westport Renal Center
Practice address
3947 Broadway St
Kansas City, MO 64111-2516
Phone
(816) 531-1181
Fax
(816) 531-1186
NPI assigned
Jan 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Samuel Wey
Title
Sr Director Licensure&Certification
Phone
(615) 341-6691

Specialties & licenses 1

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

Addresses

Primary practice location

3947 Broadway St
Kansas City, MO 64111-2516

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 341-6264

Other identifiers 1

IdentifierTypeStateIssuer
1518142710MedicaidMO

Other names 1

  • Westport Renal Center Doing business as

National Provider Directory

National Provider Directory

Member of 3

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

Locations

3947 Broadway Blvd
Kansas City, MO 64111
Phone (816) 531-1181

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1518142710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-341-6264",
            "fax_number": "800-297-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3947 BROADWAY ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112516",
            "telephone_number": "816-531-1181",
            "fax_number": "816-531-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD KANSAS CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "SR DIRECTOR LICENSURE&CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6691"
    },
    "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": "1518142710",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westport Renal Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Westport Renal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.