Lubbock Interventional Nephrology Associates PA

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

14579 Issued in TX

Legal business name

LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES PA

Practice address

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

Phone

(806) 792-2222

NPI assigned

May 11, 2017

Organization subpart

Yes

Parent organization

LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATESAs reported in NPPES

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

Authorized official

Name

Jennifer Lee Coleman, NP

Title

Facility Administration

Phone

(806) 793-8447

Specialties & licenses 1

Addresses

Other names 1

• Lubbock Vascular Access Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Lubbock Interventional Neph2 organizations share this tax ID, including this one

Part of

Lubbock Interventional Neph

Other organizations with this tax ID 1

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

• Lubbock Vascular Access Center

  • Ambulatory Surgical Clinic/Center
  • Lubbock, TX
  • NPI 1992248512
  NPD tax ID

Practitioners 4

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

• Ramakrishnan Ranganath, MD

  • Interventional Cardiology Physician
  • Lubbock, TX
  • NPI 1225213028
  Medicare reassignment NPD
• Yvette Corinne Tomacruz, M.D.

  • Internal Medicine Physician
  • Lubbock, TX
  • NPI 1700018991
  Medicare reassignment NPD
• Clarence Joseph Wheeler III, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Lubbock, TX
  • NPI 1699776732
  Medicare reassignment NPD
• Ruben Dario Villa, M.D.

  • Nephrology Physician
  • Lubbock, TX
  • NPI 1659367647
  NPD (past)

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"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• 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.