NPIMap

Organization Active NPI

NTKC Management, LLC

Doing business as North Texas Kidney Consultants

  • Nephrology Physician
  • Grapevine, TX
National Provider Identifier
1891948683
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NTKC MANAGEMENT, LLC
Doing business as
North Texas Kidney Consultants
Practice address
1601 Lancaster Dr
Suite 20C
Grapevine, TX 76051-2109
Phone
(817) 375-0610
NPI assigned
Oct 24, 2008
Last updated
Oct 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Authorized official

Name
Mr. Dan Baccus
Title
Chief Operating Officer
Phone
(817) 375-0610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1601 Lancaster Dr
Suite 20C
Grapevine, TX 76051-2109

Mailing address

3030 Matlock Rd
Suite 205
Arlington, TX 76015-2935
Phone (817) 375-0610

Other names 1

  • North Texas Kidney Consultants Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Texas Kidney Consultants3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1601 Lancaster Dr
Ste 20C
Grapevine, TX 76051
Phone (817) 251-0040

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224806400000",
    "number": "1891948683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 MATLOCK RD",
            "address_2": "SUITE 205",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152935",
            "telephone_number": "817-375-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 LANCASTER DR",
            "address_2": "SUITE 20C",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760512109",
            "telephone_number": "817-375-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NTKC MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-24",
        "last_updated": "2008-10-24",
        "status": "A",
        "authorized_official_last_name": "BACCUS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "817-375-0610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Texas Kidney Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; 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.