Kidney Care Quad Cities, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036088655 Issued in IL

Legal business name

KIDNEY CARE QUAD CITIES, LLC

Practice address

615 35TH Ave
Moline, IL 61265-6107

Phone

(309) 757-7780

Fax

(309) 757-7719

NPI assigned

Feb 11, 2009

Last updated

Jan 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Loretta Lopez

Title

Office Manager

Phone

(309) 756-6880

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Enrollment records 2

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Nadell Dialysis LLC

  dba Moline Home Training

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Moline, IL
  • NPI 1982940664

  Member Of

  NPD member
• Clyfee Dialysis LLC

  dba EA Motto Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Davenport, IA
  • NPI 1821499245

  Member Of

  NPD member

Locations

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.

• Rajendra Dahal, M.D.

  • Nephrology Physician
  • Moline, IL
  • NPI 1205830981

  IA

  Medicare reassignment NPD
• Nicole Fedele, ARNP

  • Acute Care Nurse Practitioner
  • Bettendorf, IA
  • NPI 1407257488

  IL

  Medicare reassignment NPD
• Venkateswara R Karuparthy, MD

  • Anesthesiology Physician
  • Rock Island, IL
  • NPI 1891782553
  NPD (past)
• Sara Marie Rausch, D.C.

  • Chiropractor
  • Davenport, IA
  • NPI 1033548995
  NPD (past)
• Mosali Sanjeeva Reddy, M.D.

  • Anesthesiology Physician
  • Dubuque, IA
  • NPI 1639141617
  NPD (past)

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1720227994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 35TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656107",
            "telephone_number": "309-757-7783",
            "fax_number": "309-757-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 35TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656107",
            "telephone_number": "309-757-7780",
            "fax_number": "309-757-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE QUAD CITIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "309-756-6880"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036088655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720227994",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy J Kennedy, DC
• Casey Patrick Kenney, D.M.D.
• Nicole Suzanne Kern, RD, LDN
• Kevin D Smith D P M P C
• Sandra J Khoury, MD
• Killean Audiology & Hearing Aid CTRS
• Moses Kim, M.D.
• Yeon Soo Kim, DDS
• Cassandra L King, ARNP
• Katherine King, PHARM.D.

• Nephrology Physician in Moline, IL
• Providers in Moline, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.