CLOVER DIALYSIS LLC (NPI# 1457797474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457797474 |
| Entity Type | Organization |
| Organization Name | CLOVER DIALYSIS LLC |
| Other Organization Name | STEVENS CREEK DIALYSIS |
| Practice Address |
275 Di Salvo Ave San Jose CA 95128-1628 |
| Mailing Address |
5200 Virginia Way L & C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 4082970103 |
| Practice Fax Number | 4082972265 |
| Mailing Telephone | 6153416765 |
| Mailing Fax Number | 8337829089 |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2020-03-24 |
| Authorized Official Name | JOHN D 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 |
550002503 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1457797474 | 05 |
| Other Name | Type Code |
|---|---|
| Stevens Creek Dialysis | Doing Business As Name - Organization |
| Street Address |
275 DI SALVO AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-1628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| 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 |
|---|---|---|---|---|
| 1134612468 | Kaiser Foundation Hospitals | Clinic/Center | 1721 Technology Dr Ste 245, San Jose, CA 95110-1305 | 2018-06-12 |
| 1992204481 | Satellite Dialysis of White Road LLC | Clinic/Center | 3251 S White Rd Ste 10, San Jose, CA 95148-4056 | 2018-02-09 |
| 1427572908 | Toulouse Dialysis LLC | Clinic/Center | 3501 E Capitol Expy, San Jose, CA 95122-1024 | 2017-07-27 |
| 1306299391 | Satellite Healthcare Inc | Clinic/Center | 1450 Kooser Road, San Jose, CA 95118 | 2016-07-14 |
| 1114347473 | Satellite Healthcare Inc | Clinic/Center | 4360 Stevens Creek Blvd, Suite A, San Jose, CA 95129-1103 | 2014-04-24 |
| 1972927960 | Satellite Healthcare San Jose LLC | Clinic/Center | 888 S Bascom Ave, San Jose, CA 95128-2605 | 2014-02-11 |
| 1154668184 | Total Renal Care Inc | Clinic/Center | 1290 Tully Rd, Ste 80, San Jose, CA 95122-3069 | 2013-01-10 |
| 1104187202 | Skagit Dialysis LLC | Clinic/Center | 725 Ridder Park Dr, Ste 10, San Jose, CA 95131-2431 | 2012-06-05 |
| 1386882934 | Total Renal Care Inc | Clinic/Center | 3162 S White Rd, Ste 100, San Jose, CA 95148-4019 | 2009-02-04 |
| 1578724761 | Satellite Healthcare Inc | Clinic/Center | 7019 Realm Dr, San Jose, CA 95119-1321 | 2008-06-19 |
| Find all providers in SAN JOSE | ||||
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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.