Organization Active NPI

Sunshine Kidney Care LLC

  • Nephrology Physician
  • The Villages, FL
National Provider Identifier
1639759202
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SUNSHINE KIDNEY CARE LLC
Practice address
1400 N US Highway 441 Ste 522
The Villages, FL 32159-8983
Phone
(352) 388-5800
Fax
(352) 388-7001
NPI assigned
Apr 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
John S. Hayes, MDNPI 1154520476
Title
Owner
Phone
(352) 388-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1400 N US Highway 441 Ste 522
The Villages, FL 32159-8983

Mailing address

13900 County Road 455
Unit 107 #402
Clermont, FL 34711-9052
Phone (352) 388-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210428000398 FL Part B Supplier - Clinic/Group Practice 3072921212 Receives reassigned benefits from 5 practitioners
Practice locations: The Villages, FL

National Provider Directory

National Provider Directory

Locations

13900 County Road 455
Unit 107
Clermont, FL 34711

2701 SW College Rd
Rm B12
Ocala, FL 34474

1585 Santa Barbara Blvd
#A
The Villages, FL 32159
Phone (352) 430-2121

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1639759202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13900 COUNTY ROAD 455",
            "address_2": "UNIT 107 #402",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347119052",
            "telephone_number": "352-388-5800",
            "fax_number": "352-388-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N US HIGHWAY 441 STE 522",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598983",
            "telephone_number": "352-388-5800",
            "fax_number": "352-388-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE KIDNEY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-388-5800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.