Usrc South Arlington, LLC

Primary specialty

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

Legal business name

USRC SOUTH ARLINGTON, LLC

Doing business as

Premier Dialysis - South Arlington

Practice address

801 E Border St Ste 151
Arlington, TX 76010-7494

Phone

(817) 539-6744

NPI assigned

May 21, 2020

Last updated

Jul 24, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

US RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Chairman/President

Phone

(214) 736-2732

Specialties & licenses 1

Addresses

Other names 1

• Premier Dialysis - South Arlington Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

USRC Premier South ArlingtonCCN 742586

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Jun 16, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

13

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

CLIA laboratory certificates

Part of

US Renal Care Inc

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.

• Mary O'Kief Dittrich, MD

  • Nephrology Physician
  • Meridian, ID
  • NPI 1437194552
  NPD (past)

Affiliated clinicians 2

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

• Ponnaiah C. Mohan, MD

  • Nephrology Physician
  • Arlington, TX
  • NPI 1487646295

  Dialysis facility

  Care Compare affiliation Name & address match
• Fahad Alobaidi, M.D.

  • Nephrology Physician
  • Tucson, AZ
  • NPI 1366882334

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1861015067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251549",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251500",
            "telephone_number": "214-736-2700",
            "fax_number": "214-291-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E BORDER ST STE 151",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760107494",
            "telephone_number": "817-539-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC SOUTH ARLINGTON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE, INC.",
        "enumeration_date": "2020-05-21",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN/PRESIDENT",
        "authorized_official_telephone_number": "214-736-2732"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Dialysis - South Arlington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arlington, TX
• Providers in Arlington, 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 Jul 24, 2023; 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.