Texarkana Kidney Disease & Hypertension Center, Inc
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Hope, AR
NPI 1992889596 · NPPES record last updated Mar 13, 2020
Key facts
- NPI
- 1992889596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- TEXARKANA KIDNEY DISEASE & HYPERTENSION CENTER, INC
- Practice address
- 407 W 16TH St
Hope, AR 71801-7104 - Phone
- (870) 777-1700
- Fax
- (870) 777-1701
- NPI assigned
- Oct 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. D. Michael Blankenship, MD
- Title
- President
- Phone
- (870) 773-1111
Corporate family (same tax ID) 1
Affiliated clinicians 1
Medicare Care Compare: Dialysis facility
- Listed as
- Hope Dialysis Center
- Overall star rating
- ★★★☆☆ 3.0 of 5
- Ownership
- Profit
- Certified
- Aug 16, 2002
- Medicare certification status
- Active
- Dialysis stations
- 11
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0896932 | Hope Dialysis Center | Certificate of waiver | Jan 23, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120209000682 | AR | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 4981684735 | Practice locations: Hope, AR |
National Provider Directory
- Tax ID family
- Hope Dialysis
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
407 W 16TH St
Hope, AR 71801-7104
Mailing address
422 Beech St
Texarkana, AR 71854-5310
Phone (870) 773-1111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 158823134 | Medicaid | AR |
Other names
- Hope Dialysis
Other providers in Hope, AR
- Greta D. Sweesy
- Stephen Lee Swender
- Carnisha Taylor
- Jamie Taylor
- Braden Tewalt
- The Clinic for Children, Youth and Young Adults
- Eatrice Thomas
- Tennelle O Thomas
- Devonna Tillman
- Megan Toon
All providers in Hope, AR · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.