Elik Dialysis Hometherapy - Memorial, Inc

Primary specialty

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

License

012755 Issued in TX

Legal business name

ELIK DIALYSIS HOMETHERAPY - MEMORIAL, INC

Practice address

1445 North Loop W
Suite 720
Houston, TX 77008-1661

Phone

(713) 861-7500

Fax

(713) 861-7502

NPI assigned

Jan 23, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Balbeer K Godwin, REGISTERED NURSE

Title

President/Ceo

Phone

(281) 799-7089

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Elik Dialysis Home TherapyCCN 672626

Ownership

Profit

Certified

Dec 22, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

1

Tax ID family

Elik Dialysis Home Therapy-Memorial Inc Dba Elik Dialysis Home Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elik Dialysis Home Therapy-Memorial Inc Dba Elik Dialysis Home Therapy

  • Home Health Agency
  • Houston, TX
  • NPI 1467788547
  NPD tax ID

Locations

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254441600000",
    "number": "1659558401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 NORTH LOOP WEST",
            "address_2": "SUITE 720",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081861",
            "telephone_number": "713-861-7500",
            "fax_number": "713-861-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 NORTH LOOP W",
            "address_2": "SUITE 720",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081661",
            "telephone_number": "713-861-7500",
            "fax_number": "713-861-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIK DIALYSIS HOMETHERAPY - MEMORIAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2009-10-02",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "BALBEER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "281-799-7089",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "012755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian M Eliis, D.D.S.
• Elijah Medical Clinic
• Mary E Elijah, M.ED, LPC, RPT
• Elik Dialysis Home Therapy - Memorial II LLC
• Elik Dialysis Home Therapy-Memorial Inc Dba Elik Dialysis Home Therapy
• Elena Elimova
• Julia Elina, M.S.,CCC-SLP
• Elisabeth Netherton MD LLC
• Nicholas Ryan Eliserio, M.S., CCC-SLP
• Elitair Care Home Health Agency, Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Houston, TX
• Providers in Houston, 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 Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.