TOTAL RENAL CARE INC (NPI# 1215121330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215121330 |
Entity Type | Organization |
Organization Name | TOTAL RENAL CARE INC |
Other Organization Name | BROADMOOR DIALYSIS |
Practice Address |
1815 E 70th St Shreveport LA 71105-5301 |
Mailing Address |
5200 Virginia Way L&c Department Brentwood TN 37027-7569 |
Practice Telephone | 3187977940 |
Practice Fax Number | 3187978143 |
Mailing Telephone | 6153416764 |
Mailing Fax Number | 8337816999 |
Enumeration Date | 2007-08-31 |
Last Update Date | 2020-09-21 |
Authorized Official Name | JOHN WINSTEL (CHIEF ACCOUNTING OFFICER) |
Authorized Official Telephone | 2537334501 |
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 |
2203781771 | LA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 1369322 | 05 |
Other Name | Type Code |
---|---|
Broadmoor Dialysis | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720690506 | Total Renal Care Inc | Clinic/Center | 16290 Auto Ln, Sumner, WA 98390-2568 | 2020-08-21 |
1669080107 | Total Renal Care Inc | Clinic/Center | 4270 Rosewood Dr Ste E, Pleasanton, CA 94588-3065 | 2020-07-21 |
1437798386 | Total Renal Care Inc | Clinic/Center | 1800 State Route 34 Ste 302, Wall Township, NJ 07719-9146 | 2019-12-24 |
1750939963 | Total Renal Care Inc | Clinic/Center | 7 Cambridge Dr Ste 105, Trumbull, CT 06611-4763 | 2019-08-30 |
1992358170 | Total Renal Care Inc | Clinic/Center | 1700 Markley St, Ste 122, Norristown, PA 19401-2902 | 2019-07-17 |
1760034599 | Total Renal Care Inc | Clinic/Center | 9431 Corkscrew Palms Cir, Estero, FL 33928-6275 | 2019-07-11 |
1225691447 | Total Renal Care Inc | Clinic/Center | 1115 N Nova Rd, Daytona Beach, FL 32117-4108 | 2019-04-15 |
1659839181 | Total Renal Care Inc | Clinic/Center | 645 9th St Nw, Salem, OR 97304-3132 | 2019-03-04 |
1477019388 | Total Renal Care Inc | Clinic/Center | 4539 Chiquita Blvd S, Cape Coral, FL 33914 | 2019-02-15 |
1902377591 | Total Renal Care Inc | Clinic/Center | 11859 Wilshire Blvd Ste 100, Los Angeles, CA 90025-6653 | 2018-12-08 |
Entity Type | Entity Name | Entity Address |
---|---|---|
North Carolina Corporations | Total Renal Care Inc. | 2626 Glenwood Avenue Suite 550, Raleigh, NC 27608 |
Virginia Business Entities | TOTAL RENAL CARE INC. | 2000 16th St, Jld/secgovfin, Denver, Colorado 80202-5117 |
Street Address |
1815 E 70TH ST |
City | SHREVEPORT |
State | LA |
Zip Code | 71105-5301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821603465 | Todd Campbell | Physician Assistant | 1815 E 70th St, Shreveport, LA 71105-5301 | 2020-09-10 |
1194292516 | Southern Kidney Associates Pllc | Internal Medicine | 1815 E 70th St, Shreveport, LA 71105-5301 | 2018-10-24 |
1912248931 | Total Renal Care Inc | Clinic/Center | 1815 E 70th St, Shreveport, LA 71105-5301 | 2013-03-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
Find all providers in zip 71105 |
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 |
---|---|---|---|---|
1396255311 | Dialysis Clinic Inc | Clinic/Center | 2020 Bert Kouns Industrial Loop, Shreveport, LA 71118-3315 | 2017-10-04 |
1992035232 | Total Renal Care Inc | Clinic/Center | 9205 Linwood Ave, Shreveport, LA 71106-7006 | 2010-01-08 |
1033380589 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 2240 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5358 | 2008-03-12 |
1700988185 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 410 Ashley Ridge Blvd, Shreveport, LA 71106-7228 | 2006-09-05 |
1760594527 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 990 Aero Dr, Shreveport, LA 71107-7106 | 2006-08-31 |
1336251164 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 4338 Pines Rd, Shreveport, LA 71119-7738 | 2006-08-31 |
1427160274 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 1130 Kings Hwy, Shreveport, LA 71104-2934 | 2006-08-31 |
1245342005 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 9076 Kingston Rd, Shreveport, LA 71118-3416 | 2006-08-31 |
1164534913 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 3949 Southern Ave, Shreveport, LA 71106-1035 | 2006-08-31 |
1679592810 | Dialysis Clinic Inc. | Clinic/Center | 1515 N Hearne Ave, Shreveport, LA 71107-7108 | 2006-07-19 |
Find all providers in SHREVEPORT |
City | SHREVEPORT |
Zip Code | 71105 |
Please comment or provide details below to improve the information on TOTAL RENAL CARE INC.
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.