NPIMap

Organization Active NPI

Usrc Laredo South LP

Doing business as US Renal Care Laredo South Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Laredo, TX
National Provider Identifier
1578613220
Registry record updated Oct 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
008497 Issued in TX
Legal business name
USRC LAREDO SOUTH LP
Doing business as
US Renal Care Laredo South Dialysis
Practice address
4602 Bencha Dr
Laredo, TX 78043-9701
Phone
(956) 668-8484
Fax
(956) 668-8485
NPI assigned
Jan 12, 2007
Last updated
Oct 28, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
US RENAL CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2013

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

Authorized official

Name
Mr. Thomas L Weinberg
Title
VP Legal Counsel
Phone
(214) 736-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 008497 TX Primary

Addresses

Primary practice location

4602 Bencha Dr
Laredo, TX 78043-9701

Mailing address

PO Box 19119
Jonesboro, AR 72403-6601
Phone (870) 931-5400

Other identifiers 4

IdentifierTypeStateIssuer
HH084YOtherTXBCBS
189702702MedicaidTX
021620OtherTXKIDNEY HEALTH CARE
189702701MedicaidTX

Other names 1

  • US Renal Care Laredo South Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070123000660 TX Part A Provider - End-Stage Renal Disease Facility (ESRD) 2961403654 Practice locations: Laredo, TX

National Provider Directory

National Provider Directory
Part of
US Renal Care Inc

Locations

4602 Bencha Dr
Laredo, TX 78043
Phone (956) 668-8484

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382918400000",
    "number": "1578613220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19119",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036601",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 BENCHA DR",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780439701",
            "telephone_number": "956-668-8484",
            "fax_number": "956-668-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC LAREDO SOUTH LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE INC",
        "enumeration_date": "2007-01-12",
        "last_updated": "2013-10-28",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP LEGAL COUNSEL",
        "authorized_official_telephone_number": "214-736-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "008497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "HH084Y",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189702702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KIDNEY HEALTH CARE",
            "identifier": "021620",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189702701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "US Renal Care Laredo South Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.