Renal Center of Keller, LLC

Primary specialty

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

Legal business name

RENAL CENTER OF KELLER, LLC

Practice address

10708 Victoria Ash Dr
Fort Worth, TX 76244-6392

Phone

(817) 431-6533

Fax

(817) 431-6543

NPI assigned

Aug 7, 2013

Organization subpart

No

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

Authorized official

Name

Samuel T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Renal Center of Keller Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita Renal Center of KellerCCN 672741

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Oct 1, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

21

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Renal Treatment Centers Northeast Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lehighton, PA
  • NPI 1598727372

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raghuveer Vanguru, M.D.

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1700891579
  NPD (past)

Affiliated clinicians 2

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

• Davinder Singh, M.D.

  • Nephrology Physician
  • Arlington, TX
  • NPI 1194945592

  Dialysis facility

  Care Compare affiliation Name & address match
• Raghuveer Vanguru, M.D.

  • Nephrology Physician
  • Fort Worth, TX
  • NPI 1700891579

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1770915217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10708 VICTORIA ASH DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446392",
            "telephone_number": "817-431-6533",
            "fax_number": "817-431-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL CENTER OF KELLER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-07",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3439457-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renal Center of Keller",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Remarkable Healthcare of Fort Worth, LP
• Bryana Dechal Remble
• Remedios R. Cabansag , MD, PA
• Molly Grace Remondino, DO
• Renaissance Eyecare
• Andrew Duncan Renaud, D.C.
• Bailey Renaud, DC
• Logan Ray Rencher, DO
• Gabrielle Rendon, LPC
• Ashley Nicole Reneau, PT, DPT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, 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 3, 2024; 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.