SRS-Westlake, LLC

Primary specialty

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

Legal business name

SRS-WESTLAKE, LLC

Practice address

30770 Russell Ranch Rd
Westlake Village, CA 91362-6314

Phone

(615) 467-0140

Fax

(615) 259-0693

NPI assigned

Mar 4, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Seymour Tannenbaum, M.D., PH.D., FACP

Title

Ceo

Phone

(615) 500-8021

Specialties & licenses 1

Addresses

Other names 1

• SRS Dialysis-Westlake Doing business as

Locations

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1669129110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198813",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372198813",
            "telephone_number": "615-467-0140",
            "fax_number": "615-259-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30770 RUSSELL RANCH RD",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913626314",
            "telephone_number": "615-467-0140",
            "fax_number": "615-259-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRS-WESTLAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "TANNENBAUM",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "SEYMOUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-500-8021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D., FACP"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRS Dialysis-Westlake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SRS Dialysis-Westlake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.