Northwest Renal Clinic, Inc.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

NORTHWEST RENAL CLINIC, INC.

Practice address

105 Maui Lani Pkwy Ste 100
Wailuku, HI 96793-2443

Phone

(808) 442-7777

Fax

(808) 442-7778

NPI assigned

Nov 4, 2019

Organization subpart

Yes

Parent organization

NORTHWEST RENAL CLINIC, INC.As reported in NPPES

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

Authorized official

Name

Clayton Michael Smiley, MD

Title

President / MD

Phone

(503) 229-7976

Specialties & licenses 1

Addresses

Other names 1

• Island Kidney Care Doing business as

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

CLIA laboratory certificates

Tax ID family

Northwest Renal CL Inc9 organizations share this tax ID, including this one

Part of

Northwest Renal CL Inc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

• Northwest Renal Clinic, Inc.

  • Ambulatory Surgical Clinic/Center
  • Portland, OR
  • NPI 1164946984
  NPD tax ID
• Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • McMinnville, OR
  • NPI 1346081213
  NPD tax ID
• Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • Salem, OR
  • NPI 1396378717
  NPD tax ID
• Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • Tualatin, OR
  • NPI 1679752273
  NPD tax ID
• Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • Clackamas, OR
  • NPI 1689117087
  NPD tax ID
• Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • Hillsboro, OR
  • NPI 1750748901
  NPD tax ID
• Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • Portland, OR
  • NPI 1780865642
  NPD tax ID
• Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • Portland, OR
  • NPI 1861700130
  NPD tax ID

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1780228544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 640",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105488",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MAUI LANI PKWY STE 100",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932443",
            "telephone_number": "808-442-7777",
            "fax_number": "808-442-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST RENAL CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST RENAL CLINIC, INC.",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "SMILEY",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT / MD",
        "authorized_official_telephone_number": "503-229-7976",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Island Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Island Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Constantin Novoselsky, MD
• Nphousecall, Inc.
• Vincent E Nubla, PH.D., LMFT
• Craig Vernon Nunokawa, D.D.S.

• Nephrology Physician in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Nephrology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.