KIDNEY CARE SERVICES OF HUMBOLDT
NPI 1457734741
Internal Medicine - Nephrology in Eureka, CA

Q: What is Kidney Care Services Of Humboldt's NPI number?

The NPI number for Kidney Care Services Of Humboldt is 1457734741. It was assigned to this organization in the NPPES registry on July 4, 2015.

Q: What is Kidney Care Services Of Humboldt's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Active since July 04, 2015

1651 MYRTLE AVE STE C, EUREKA, CA 95501(707) 599-6700(888) 475-8698 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 4, 2026, Apr 30, 2024, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

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About Kidney Care Services Of Humboldt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIDNEY CARE SERVICES OF HUMBOLDT (NPI 1457734741) is a healthcare organization registered as a nephrology in Eureka, California and active in the NPI registry since July 2015. The organization maintains 2 additional practice locations and lists James Lee Wynn, Admin Aide, as its authorized official.

NPPES Registry Identity

NPI1457734741

Entity TypeOrganization

Primary Taxonomy207RN0300X

Legal Business NameKIDNEY CARE SERVICES OF HUMBOLDT

Location Address1651 MYRTLE AVE STE CEureka, CA 95501-1495

Mailing Address1651 Myrtle Ave Ste CEureka, CA 95501-1495 · (707) 599-6700 · Fax (888) 475-8698

Phone(707) 599-6700

Fax(888) 475-8698

Organization SubpartNo

Authorized OfficialJames Lee WynnAdmin Aide · (707) 599-6700

Enumeration DateJuly 4, 2015

Last NPPES UpdateJune 4, 20264 updates tracked since enumeration

NPPES CertifiedJune 4, 2026

✔ NPI 1457734741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in CA · 23313

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

Also ListedNon-Pharmacy Dispensing SiteTaxonomy 332900000X

1651 MYRTLE AVE STE C, Eureka, CA 95501

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Secondary Practice Locations 2

Location 12765 Timber Ridge LnEureka, CA 95503-4885 · Phone (707) 445-2033 · Fax (707) 445-8026

Location 21550 Heartwood DrMcKinleyville, CA 95519-3984 · Phone (707) 839-4465 · Fax (707) 839-4734

Other Identifiers 1

MedicaidRN846580CA

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kidney Care Services Of Humboldt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kidney Care Services Of Humboldt, which bills Medicare for the services this clinician delivers.

Clinician (1)

Angela Smith, CNP

Nurse Practitioner

NPI 1023368453

1651 MYRTLE AVE STE C
Eureka, CA 95501

(707) 599-6700

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kidney Care Services Of Humboldt's NPI number?

The NPI number for Kidney Care Services Of Humboldt is 1457734741. It was assigned to this organization in the NPPES registry on July 4, 2015.

Where is Kidney Care Services Of Humboldt located?

Kidney Care Services Of Humboldt is located at 1651 Myrtle Ave Ste C, Eureka, CA 95501. The listed phone number is (707) 599-6700.

What is Kidney Care Services Of Humboldt's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Kidney Care Services Of Humboldt enrolled in Medicare?

Yes. Kidney Care Services Of Humboldt is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kidney Care Services Of Humboldt?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Kidney Care Services Of Humboldt. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kidney Care Services Of Humboldt was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.