NPIMap

Organization Active NPI

Kidney Specialists of South Texas, P.a.

  • Nephrology Physician
  • Corpus Christi, TX
National Provider Identifier
1699778068
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
KIDNEY SPECIALISTS OF SOUTH TEXAS, P.A.
Practice address
1521 S Staples St
Ste 601
Corpus Christi, TX 78404-3154
Phone
(361) 887-8451
Fax
(361) 887-6126
NPI assigned
May 31, 2005
Last updated
Dec 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Dr. Shah F Islam, M.D.NPI 1841293727
Title
President
Phone
(361) 887-8451

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 Physician 207RN0300X NU Primary

Addresses

Primary practice location

1521 S Staples St
Ste 601
Corpus Christi, TX 78404-3154

Mailing address

850 W Rio Salado Pkwy Ste 201
Tempe, AZ 85281-3812
Phone (361) 887-8451

Other identifiers 1

IdentifierTypeStateIssuer
109425201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819000302 TX Part B Supplier - Clinic/Group Practice 0244203958 Receives reassigned benefits from 9 practitioners
Practice locations: Corpus Christi, TX

National Provider Directory

National Provider Directory

Locations

850 W Rio Salado Pkwy
Ste 201
Tempe, AZ 85281

1315 Santa Fe St
Ste 102
Corpus Christi, TX 78404
Phone (361) 992-3500

1521 S Staples St
Ste 601
Corpus Christi, TX 78404
Phone (361) 887-8451

5826 Esplanade Dr
Ste 204
Corpus Christi, TX 78414
Phone (361) 994-4858

Practitioners & affiliated clinicians

Practitioners 11

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": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1699778068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W RIO SALADO PKWY STE 201",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852813812",
            "telephone_number": "361-887-8451",
            "fax_number": "361-887-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 S STAPLES ST",
            "address_2": "STE 601",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784043154",
            "telephone_number": "361-887-8451",
            "fax_number": "361-887-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY SPECIALISTS OF SOUTH TEXAS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "ISLAM",
        "authorized_official_first_name": "SHAH",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-887-8451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109425201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.