Kidney House PLLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP125430 Issued in TX

Legal business name

KIDNEY HOUSE PLLC

Practice address

1705 Martin Luther King Jr Blvd
Suite C
Dallas, TX 75215-3222

Phone

(214) 425-5935

Fax

(972) 919-0425

NPI assigned

Apr 29, 2015

Organization subpart

No

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

Authorized official

Name

Derrick Love-Jones

Title

Ceo

Phone

(817) 781-2250

Specialties & licenses 1

Addresses

Other names 1

• The Kidney House Doing business as

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1558748459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 SKILLMAN ST",
            "address_2": "SUITE 110-359",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752068559",
            "telephone_number": "214-425-5935",
            "fax_number": "972-919-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE C",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752153222",
            "telephone_number": "214-425-5935",
            "fax_number": "972-919-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY HOUSE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "LOVE-JONES",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-781-2250"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP125430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kidney House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mehgan Kidd, MD
• Michaela Angelea Kidd, CAA
• Mary Kidder, LCSW
• Kidney and Hypertension Associates of Dallas PLLC
• Kidney Care of Dallas PLLC
• Michal Kidron, PHD, LPC, NCC,
• Kids Brain, LLC
• Kids First Pediatric Home Health Agency Inc
• Kids T.L.C. the Language Connection LLC
• Yousuf Ali Kidwai, MD

• Primary Care Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.