Organization Active NPI

Center for Diseases of the Kidney & Hypertension Inc

  • Specialist
  • Mount Dora, FL
National Provider Identifier
1720038219
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0043444 Issued in FL
Legal business name
CENTER FOR DISEASES OF THE KIDNEY & HYPERTENSION INC
Practice address
3801 N Highway 19a
Suite 400
Mount Dora, FL 32757-2228
Phone
(352) 383-1245
Fax
(352) 383-4401
NPI assigned
May 12, 2006
Last updated
Mar 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Authorized official

Name
Ruth Meneses-Taylor, MDNPI 1033161351
Title
President
Phone
(353) 383-1245

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME0043444 FL Primary

Addresses

Primary practice location

3801 N Highway 19a
Suite 400
Mount Dora, FL 32757-2228

Mailing address

3801 N Highway 19a
Suite 400
Mount Dora, FL 32757-2228
Phone (352) 383-1245

Other identifiers 1

IdentifierTypeStateIssuer
048255200MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000640 FL Part B Supplier - Clinic/Group Practice 4880583087 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Dora, FL

National Provider Directory

National Provider Directory

Locations

745 Highway 466
Lady Lake, FL 32159
Phone (352) 383-1245

3912 W Riv Dr Ste 5
Corpus Christi, TX 78410

Practitioners & affiliated clinicians

Practitioners 2

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": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1720038219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N HIGHWAY 19A",
            "address_2": "SUITE 400",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572228",
            "telephone_number": "352-383-1245",
            "fax_number": "352-383-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 N HIGHWAY 19A",
            "address_2": "SUITE 400",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572228",
            "telephone_number": "352-383-1245",
            "fax_number": "352-383-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR DISEASES OF THE KIDNEY & HYPERTENSION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "MENESES-TAYLOR",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "353-383-1245",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0043444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048255200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; 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.