Wichita Falls Kidney Dialysis LLC

Primary specialty

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

Legal business name

WICHITA FALLS KIDNEY DIALYSIS LLC

Practice address

1104 Holliday St
Wichita Falls, TX 76301-4422

Phone

(940) 716-0557

NPI assigned

Sep 7, 2016

Last updated

Jan 26, 2020By 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

Jayasankar Reddy, M.DNPI 1174562276

Title

Director

Phone

(940) 716-0557

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jayasankar K Reddy, MD

  • Nephrology Physician
  • Wichita Falls, TX
  • NPI 1174562276
  NPD Authorized official

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579996800000",
    "number": "1598212573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 10TH ST",
            "address_2": "STE B",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014401",
            "telephone_number": "940-716-0557",
            "fax_number": "940-355-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 HOLLIDAY ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014422",
            "telephone_number": "940-716-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA FALLS KIDNEY DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2020-01-26",
        "certification_date": "2020-01-26",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "JAYASANKAR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "940-716-0557",
        "authorized_official_credential": "M.D"
    },
    "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": "3964322-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "HH486Y",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wichita Falls Heart Clinic PLLC
• Wichita Falls I Enterprises, LLC (University Park Nursing & Rehabilitation)
• Wichita Falls Infectious Disease Assoc. P.a. (Robert L McBroom MD)
• Wichita Falls Isd
• Wichita Falls Kidney Clinic PA
• Wichita Falls Nephrology Associates, PLLC
• Wichita Falls Oral and Facial Surgery, PLLC (Texoma Facial and Oral Surgery)
• Wichita Falls Physician Billing Services, LLC
• Wichita Falls Podiatry PLLC
• Wichita Falls Podiatry, PLLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2020; 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.