Usrc Canton LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

008728 Issued in TX

Legal business name

USRC CANTON LLC

Doing business as

US Renal Care Canton Dialysis

Practice address

400 E Hwy 243
Suite 14
Canton, TX 75103-2445

Phone

(903) 567-2250

Fax

(903) 567-2209

NPI assigned

Jun 18, 2008

Organization subpart

Yes

Parent organization

US RENAL CARE INCAs reported in NPPES

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

Authorized official

Name

Thomas L Weinberg

Title

Senior Vice President

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• US Renal Care Canton Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Usrc Canton DialysisCCN 672607

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Aug 10, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

13

Part of

US Renal Care Inc

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Corey D Ball, M.D.

  • Nephrology Physician
  • Tyler, TX
  • NPI 1346433216

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1750542213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19119",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036601",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E HWY 243",
            "address_2": "SUITE 14",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751032445",
            "telephone_number": "903-567-2250",
            "fax_number": "903-567-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC CANTON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE INC",
        "enumeration_date": "2008-06-18",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "008728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207362902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHC",
            "identifier": "025047",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "US Renal Care Canton Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Katherine Benay Turner
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• Vitalcare Labs, LLC
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LP
• Walgreen Co

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Canton, TX
• Providers in Canton, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.