The Kidney Group of Clearwater, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

THE KIDNEY GROUP OF CLEARWATER, LLC

Practice address

617 Lakeview Rd
Suite B
Clearwater, FL 33756-3338

Phone

(727) 441-8590

Fax

(727) 441-8805

NPI assigned

Jul 13, 2006

Last updated

Nov 30, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

June A Clark

Title

Vice President

Phone

(727) 733-2040

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1588689152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 BAYSHORE BLVD",
            "address_2": "SUITE C",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346982576",
            "telephone_number": "727-733-2040",
            "fax_number": "727-733-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 LAKEVIEW RD",
            "address_2": "SUITE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563338",
            "telephone_number": "727-441-8590",
            "fax_number": "727-441-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KIDNEY GROUP OF CLEARWATER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JUNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "727-733-2040"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Clearwater, FL
• Providers in Clearwater, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.