NPIMap

Organization Active NPI

Lubbock Interventional Nephrology Associates PA

Doing business as Lubbock Vascular Access

  • Ambulatory Surgical Clinic/Center
  • Lubbock, TX
National Provider Identifier
1669909404
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
14579 Issued in TX
Legal business name
LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES PA
Doing business as
Lubbock Vascular Access
Practice address
1126 Slide Rd
Suite # 1
Lubbock, TX 79416-5462
Phone
(806) 792-2222
NPI assigned
May 11, 2017
Last updated
Aug 25, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Authorized official

Name
Jennifer Lee Coleman, NPNPI 1548349467
Title
Facility Administration
Phone
(806) 793-8447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 14579 TX Primary

Addresses

Primary practice location

1126 Slide Rd
Suite # 1
Lubbock, TX 79416-5462

Mailing address

1126 Slide Rd
Suite # 1
Lubbock, TX 79416-5462
Phone (806) 792-2222

Other names 1

  • Lubbock Vascular Access Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170424001868 TX Part B Supplier - Ambulatory Surgical Center 0042596280 Receives reassigned benefits from 3 practitioners
Practice locations: Lubbock, TX

National Provider Directory

National Provider Directory
Tax ID family
Lubbock Interventional Nephrology Associates PA2 organizations share this tax ID, including this one
Part of
Lubbock Interventional Nephrology Associates PA

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1669909404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 SLIDE RD",
            "address_2": "SUITE # 1",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794165462",
            "telephone_number": "806-792-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 SLIDE RD",
            "address_2": "SUITE # 1",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794165462",
            "telephone_number": "806-792-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATION",
        "authorized_official_telephone_number": "806-793-8447",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "14579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lubbock Vascular Access",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.