NPIMap

Organization Active NPI

Davita Nephrology Medical Associates of Ca, Inc.

  • Specialist
  • Arlington, TX
National Provider Identifier
1992922256
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CA, INC.
Practice address
3030 Matlock Rd
Suite 205
Arlington, TX 76015-2935
Phone
(817) 375-0610
Fax
(817) 375-0640
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Dan Baccus
Title
Manager, Practice Operations
Phone
(817) 375-0610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3030 Matlock Rd
Suite 205
Arlington, TX 76015-2935

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
Davita Nephrology Medical Associates of California Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992922256",
    "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",
            "fax_number": "817-375-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 MATLOCK RD",
            "address_2": "SUITE 205",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152935",
            "telephone_number": "817-375-0610",
            "fax_number": "817-375-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACCUS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "MANAGER, PRACTICE OPERATIONS",
        "authorized_official_telephone_number": "817-375-0610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "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 Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.