Wellbound of Modesto LLC

Primary specialty

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

Legal business name

WELLBOUND OF MODESTO LLC

Doing business as

Satellite WellBound of North Modesto

Practice address

4207 Bangs Ave
Ste 200
Modesto, CA 95356-8714

Phone

(209) 338-2540

Fax

(209) 543-3897

NPI assigned

Apr 18, 2013

Last updated

Dec 29, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

SATELLITE HEALTHCARE INCAs reported in NPPES

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

Authorized official

Name

Susan L Del Bene

Title

Secretary/Cfo

Phone

(650) 404-3618

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Satellite WellBound of North Modesto Doing business as

Part of

Satellite Dialysis CTRS Inc

Member of 2

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

• Satellite Healthcare, Inc.

  dba Satellite Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Mateo, CA
  • NPI 1730110578

  Member Of

  NPD member
• Wellbound of San Jose, LLC

  dba WellBound of San Mateo

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Mateo, CA
  • NPI 1023161734

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Ronak Chandrakant Shah, M.D.

  • Nephrology Physician
  • Modesto, CA
  • NPI 1033145800
  NPD (past)

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1841634144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SANTANA ROW",
            "address_2": "STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282423",
            "telephone_number": "209-338-2540",
            "fax_number": "650-625-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 BANGS AVE",
            "address_2": "STE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568714",
            "telephone_number": "209-338-2540",
            "fax_number": "209-543-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLBOUND OF MODESTO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SATELLITE HEALTHCARE INC",
        "enumeration_date": "2013-04-18",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "DEL BENE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY/CFO",
        "authorized_official_telephone_number": "650-404-3618"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841634144",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satellite WellBound of North Modesto",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Duane Welch, D.C.
• Marla Larimer Welch, D.C.
• Henok Weldeslassie
• Shewit K Weldetensae, MD
• Sophia S Weldon
• Wellbound of Modesto LLC (WellBound of Modesto)
• David I Wells, DPM
• Jessica Wells
• Jocelyn Elizabeth Wells
• Katelyn Jeane Wells, MS, LPCC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Modesto, CA
• Providers in Modesto, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.