ESTRELLA MOUNTAIN DIALYSIS LLC (NPI# 1063767739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063767739 |
Entity Type | Organization |
Organization Name | ESTRELLA MOUNTAIN DIALYSIS LLC |
Practice Address |
9250 W Thomas Rd Suite 120 Phoenix AZ 85037-3382 |
Practice Telephone | 6237727363 |
Practice Fax Number | 6237727364 |
Mailing Telephone | 6237727363 |
Mailing Fax Number | 6237727364 |
Enumeration Date | 2012-07-19 |
Last Update Date | 2020-03-11 |
Authorized Official Name | SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY) |
Authorized Official Telephone | 9789223080 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 802100 | 05 |
Street Address |
9250 W THOMAS RD SUITE 120 |
City | PHOENIX |
State | AZ |
Zip Code | 85037-3382 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124009352 | Jon A King | Surgery | 9250 W Thomas Rd, Ste 250, Phoenix, AZ 85037-3382 | 2005-11-05 |
1114431905 | Travis Nichols | Psychologist | 9250 W Thomas Rd, Phoenix, AZ 85037-3382 | 2017-12-01 |
1033623285 | Jordan Butay | Physical Therapist | 9250 W Thomas Rd, Phoenix, AZ 85037-3382 | 2017-11-27 |
1821471913 | Arizona Surgical Specialists Center, LLC | Clinic/Center | 9250 W Thomas Rd, Suite 220, Phoenix, AZ 85037-3382 | 2015-07-07 |
1477956621 | The Pain Center of Arizona, PC | Durable Medical Equipment & Medical Supplies | 9250 W Thomas Rd, Suite 200, Phoenix, AZ 85037-3382 | 2014-10-02 |
1114333432 | The Pain Center of Arizona, PC | Non-Pharmacy Dispensing Site | 9250 W Thomas Rd, Suite 200, Phoenix, AZ 85037-3382 | 2014-07-08 |
1891031019 | Manjit K Wright | Physician Assistant | 9250 W Thomas Rd, Suite 100, Phoenix, AZ 85037-3382 | 2012-12-15 |
1477824894 | Alice Mustapha Amara | Nurse Practitioner | 9250 W Thomas Rd, Suite 200, Phoenix, AZ 85037-3382 | 2012-01-17 |
1770787863 | David Wayne Smith | Surgery | 9250 W Thomas Rd, Suite 250, Phoenix, AZ 85037-3382 | 2007-06-12 |
1497959589 | Ravia Bokhari | Surgery | 9250 W Thomas Rd, Ste 250, Phoenix, AZ 85037-3382 | 2007-06-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356969828 | Live Well Assisted Living LLC | Psychiatric Residential Treatment Facility | 9210 W Loow Bend Lane, Phoenix, AZ 85037 | 2020-07-10 |
1770126260 | Medical Management Systems, Inc. | Assisted Living Facility | 2209 N. Rascon Loop, Phoenix, AZ 85037 | 2019-10-28 |
1346800760 | Sonoran Sky Family Dentistry | Dentist | 9515 West Camelback Road, Suite #120, Phoenix, AZ 85037 | 2019-06-18 |
1578025136 | Jennifer Natasha Kunz | Nurse Practitioner | Cleanslate, 8410 W. Thomas Rd, Phoenix, AZ 85037 | 2019-04-03 |
1740751320 | Mariposa Phoenix Al Partners, Lp | Assisted Living Facility | 3100 N 91st Avenue, Phoenix, AZ 85037 | 2018-12-08 |
1417442799 | Prop Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9250 W Thomas Rd Ste 220, Phoenix, AZ 85037 | 2018-06-28 |
1922522242 | Tree of Life Mental Health Systems, LLC | Behavior Technician | 8400 W. Virginia, #1138, Phoenix, AZ 85037 | 2017-07-28 |
1720500465 | Moc Phoenix, LLC | Assisted Living Facility | 3000 N. 91st Avenue, Phoenix, AZ 85037 | 2017-07-14 |
1407385826 | Not Alone Home Care, LLC | In Home Supportive Care | 9422 W Palm Lane, Phoenix, AZ 85037 | 2017-06-08 |
1063953081 | Karla Soward | Radiologic Technologist | 2015 N Rascon Loop, Phoenix, AZ 85037 | 2017-03-09 |
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Taxonomy Code | 261QE0700X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | End-Stage Renal Disease (ESRD) Treatment |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649730953 | Scottsdale Kidney Center LLC | Clinic/Center | 6970 E Chauncey Ln Ste 130, Phoenix, AZ 85054-5159 | 2019-03-22 |
1932688256 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 926 E Mcdowell Rd Ste 100, Phoenix, AZ 85006-2503 | 2018-08-08 |
1982152484 | Bio-medical Applications of Arizona, LLC | Clinic/Center | 4901 W Mcdowell Rd Ste 120, Phoenix, AZ 85035-4160 | 2016-09-14 |
1528442779 | Bio-medical Applications of Arizona, LLC | Clinic/Center | 16605 N 28th Ave Ste 100, Phoenix, AZ 85053-7551 | 2015-07-17 |
1295070761 | Calaveras Dialysis LLC | Clinic/Center | 5115 E Thomas Rd, Ste 115, Phoenix, AZ 85018-7914 | 2012-12-10 |
1801050604 | Southwest Kidney-davita Dialysis Partners LLC | Clinic/Center | 3540 E Baseline Rd Ste 110, Phoenix, AZ 85042-9628 | 2008-07-11 |
1770758526 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 4845 W Mcdowell Rd, Ste 10a, 20a, 30a, Phoenix, AZ 85035-4076 | 2008-04-23 |
1891897211 | Bio-medical Applications of Arizona, LLC | Clinic/Center | 1957 W Dunlap Ave Ste 6c, Phoenix, AZ 85021-2985 | 2006-09-05 |
1053423954 | Bio-medical Applications of Arizona LLC | Clinic/Center | 3421 N 7th Ave, Phoenix, AZ 85013-3635 | 2006-08-31 |
1477665289 | Renal Dimensions, LLC | Clinic/Center | 15930 S 48th St, Suite 100, Phoenix, AZ 85048-0903 | 2006-08-31 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.