NPIMap

Organization Active NPI

My Kidney Center, LLC

  • Medical Specialty Clinic/Center
  • Manhattan, KS
National Provider Identifier
1770823668
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
MY KIDNEY CENTER, LLC
Practice address
1133 College Ave
Building B, Suite 100
Manhattan, KS 66502-2770
Phone
(785) 565-9500
Fax
(785) 565-9595
NPI assigned
Feb 28, 2013
Last updated
Aug 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Dr. Fadi V Bedros, MDNPI 1407893290
Title
Owner
Phone
(785) 565-9500

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
Medical Specialty Clinic/Center 261QM2500X KS Primary

Addresses

Primary practice location

1133 College Ave
Building B, Suite 100
Manhattan, KS 66502-2770

Mailing address

1133 College Ave
Building B, Suite 100
Manhattan, KS 66502-2770
Phone (785) 565-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130513000496 KS Part B Supplier - Clinic/Group Practice 3274770136 Receives reassigned benefits from 4 practitioners
Practice locations: Clay Center, KS; Council Grove, KS; Junction City, KS; Manhattan, KS; Marysville, KS; Wamego, KS; Abilene, KS

National Provider Directory

National Provider Directory

Locations

1106 Saint Marys Rd
Ste 107
Junction City, KS 66441
Phone (785) 223-5555

1133 College Ave
Bldg 224
Manhattan, KS 66502

1133 College Ave
Ste 224
Manhattan, KS 66502
Phone (785) 565-9500

1133 College Ave
Ste B110
Manhattan, KS 66502

1133 College Ave
Ste B224
Manhattan, KS 66502
Phone (785) 537-9349

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1770823668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE",
            "address_2": "BUILDING B, SUITE 100",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022770",
            "telephone_number": "785-565-9500",
            "fax_number": "785-565-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE",
            "address_2": "BUILDING B, SUITE 100",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022770",
            "telephone_number": "785-565-9500",
            "fax_number": "785-565-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY KIDNEY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "BEDROS",
        "authorized_official_first_name": "FADI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-565-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.