Clinical Nephrology Associates, PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

CLINICAL NEPHROLOGY ASSOCIATES, PA

Practice address

920 Santa Fe Dr
Suite 103
Weatherford, TX 76086-5864

Phone

(817) 923-8050

Fax

(817) 923-8832

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jack O Gratch, DO

Title

Ceo

Phone

(817) 927-2612

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1811025117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 470787",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761470787",
            "telephone_number": "817-923-8050",
            "fax_number": "817-923-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 SANTA FE DR",
            "address_2": "SUITE 103",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865864",
            "telephone_number": "817-923-8050",
            "fax_number": "817-923-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL NEPHROLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "GRATCH",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-927-2612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085155203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "00209W",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CT1051",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ana Karen Clark
• Kelly Clark
• Shelby Caitlin-Lucinda Clark
• Clear Approach PLLC
• Clearsky Care Connections, LLC
• Britni Hope Cobb, OTR
• Gary Cody Coffman
• Wade M Cole, DC
• Paul David Colletti, RPH
• Madeline Collins

• Nephrology Physician in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.