Provider Demographics
NPI:1376740555
Name:NRA-UKMC, KANSAS, LLC
Entity Type:Organization
Organization Name:NRA-UKMC, KANSAS, LLC
Other - Org Name:UNIVERSITY PHYSICIANS DIALYSIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:6401 PARALLEL PKWY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-1042
Mailing Address - Country:US
Mailing Address - Phone:913-299-1044
Mailing Address - Fax:913-328-0597
Practice Address - Street 1:6401 PARALLEL PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1042
Practice Address - Country:US
Practice Address - Phone:913-299-1044
Practice Address - Fax:913-328-0597
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-29
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSNOT STATE REQUIRED261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSPENDINGMedicaid
KS17D1074541OtherCLIA
KS172547Medicare Oscar/Certification