CVS-SHC KIDNEY CARE HOME DIALYSIS OF AUSTIN LLC (NPI# 1477174951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477174951 |
| Entity Type | Organization |
| Organization Name | CVS-SHC KIDNEY CARE HOME DIALYSIS OF AUSTIN LLC |
| Practice Address |
12176 N Mo Pac Expy Ste A Austin TX 78758-2908 |
| Mailing Address |
300 Santana Row Ste 300 San Jose CA 95128-2424 |
| Practice Telephone | 5128336695 |
| Practice Fax Number | 5128144386 |
| Mailing Telephone | 6504043655 |
| Mailing Fax Number | 6506256007 |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-05-06 |
| Authorized Official Name | KARI HOLLOWAY (VP) |
| Authorized Official Telephone | 4042905964 |
| 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 |
|---|---|---|---|
| TX | BUSINESS LICENSE | 110006 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Kidney Care Home Dialysis Satellite Healthcare WellBound | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063033520 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 10000 Metric Blvd Ste 100, Austin, TX 78758-5210 | 2020-05-06 |
| 1770104481 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 10001 S Ih 35 Ste 100, Austin, TX 78747-1701 | 2020-05-04 |
| 1194346809 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 1801 E 51st St Ste 100, Austin, TX 78723-3444 | 2020-05-04 |
| 1467073171 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 16010 Park Valley Dr Ste 100, Round Rock, TX 78681-3575 | 2020-05-04 |
| 1720609431 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 1701 W Ben White Blvd Ste 180, Austin, TX 78704-7680 | 2020-05-04 |
| 1023639739 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 9811 S Interstate Highway 35 Ste 100, Austin, TX 78744-7901 | 2020-05-04 |
| 1811518525 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 134 Elmhurst Drive, Kyle, TX 78640-6060 | 2020-05-04 |
| Street Address |
12176 N MO PAC EXPY STE A |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758-2908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
| Find all providers in zip 78758 | ||||
| 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 |
|---|---|---|---|---|
| 1063033520 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 10000 Metric Blvd Ste 100, Austin, TX 78758-5210 | 2020-05-06 |
| 1770104481 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 10001 S Ih 35 Ste 100, Austin, TX 78747-1701 | 2020-05-04 |
| 1194346809 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 1801 E 51st St Ste 100, Austin, TX 78723-3444 | 2020-05-04 |
| 1720609431 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 1701 W Ben White Blvd Ste 180, Austin, TX 78704-7680 | 2020-05-04 |
| 1023639739 | Cvs-shc Kidney Care Home Dialysis of Austin LLC | Clinic/Center | 9811 S Interstate Highway 35 Ste 100, Austin, TX 78744-7901 | 2020-05-04 |
| 1538791298 | Renal Treatment Centers - Southeast, Lp | Clinic/Center | 7912 Cameron Rd, Austin, TX 78754-3826 | 2020-02-10 |
| 1992346316 | Cdi Health, LLC | Clinic/Center | 1717 W 6th St Ste 350, Austin, TX 78703-4870 | 2019-10-07 |
| 1376100818 | Nicona Dialysis LLC | Clinic/Center | 9010 Brodie Lane, Bldg A, Austin, TX 78748-5184 | 2019-05-21 |
| 1013357110 | Satellite Wellbound of South Austin, LLC | Clinic/Center | 9811 S Ih 35, Bldg 4 Suite 200, Austin, TX 78744 | 2013-07-03 |
| 1518234525 | Renal Treatment Centers Southeast Lp | Clinic/Center | 3601 Manor Rd, Austin, TX 78723-5816 | 2011-11-18 |
| Find all providers in AUSTIN | ||||
Please comment or provide details below to improve the information on CVS-SHC KIDNEY CARE HOME DIALYSIS OF AUSTIN LLC.
| 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.