The Kidney Care Center, LLC

Key facts

NPI

1801420864

Entity type

Organization (NPI type 2)

Primary specialty

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

Legal business name

THE KIDNEY CARE CENTER, LLC

Practice address

3702 Interstate 27
Lubbock, TX 79412

Phone

(806) 429-1054

Fax

(806) 256-7077

NPI assigned

Feb 28, 2020

Organization subpart

No

Authorized official

Name

Shontal Carruth

Title

Billing Manager

Phone

(806) 771-0906

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• The Kidney Care Center, LLC End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Hobbs, NM · NPI 1043610819
  Same PAC ID 0648423533

Corporate family (same tax ID) 1

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

• The Kidney Care Center, LLC End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Hobbs, NM · NPI 1043610819
  NPD tax ID

Member organizations 1

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

• The Kidney Care Center, LLC End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Lubbock, TX · NPI 1518233212
  NPD member Member Of

Practitioners 1

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

• Clarence Joseph Wheeler III, M.D. Sleep Medicine (Internal Medicine) Physician · Lubbock, TX · NPI 1699776732
  NPD (past)

Affiliated clinicians 4

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

• Elmoutaz Tawfig Mousa, M.D. Nephrology Physician · Lubbock, TX · NPI 1124287735
  Care Compare affiliation Name & address match Dialysis facility
• Nayankumar Amrutbhai Patel, MD Nephrology Physician · Lubbock, TX · NPI 1972796985
  Care Compare affiliation Name & address match Dialysis facility
• Maybin Simfukwe, MD Nephrology Physician · Lubbock, TX · NPI 1689635559
  Care Compare affiliation Name & address match Dialysis facility
• Clarence Joseph Wheeler III, M.D. Sleep Medicine (Internal Medicine) Physician · Lubbock, TX · NPI 1699776732
  Care Compare affiliation Name & address match Dialysis facility

Medicare Care Compare: Dialysis facility

Listed as

Kidney Care Center Lubbock CCN 742573

Overall star rating

★☆☆☆☆ 1.0 of 5

Ownership

Profit

Certified

Feb 3, 2021

Medicare certification status

Active (Provider of Services file)

Chain

Other

Dialysis stations

12

Source: Medicare Care Compare. Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TX

Medicare enrollment records

National Provider Directory

Tax ID family

The Kidney Care Center LLC (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

Other names

• The Kidney Care Center, LLC - Lubbock Doing business as
• The Kidney Care Center, LLC-Lubbock Doing business as

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All providers in Lubbock, TX · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas