| Entity Name: | NATIONAL KIDNEY PARTNERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
NATIONAL KIDNEY PARTNERS, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 02 Feb 2021 (4 years ago) |
| Document Number: | L21000034201 |
| FEI/EIN Number |
59-3068073
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 14134 NEPHRON LANE, HUDSON, FL, 34467, US |
| Mail Address: | 14134 NEPHRON LANE, HUDSON, FL, 34467, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780684795 | 2005-08-01 | 2024-04-24 | 14134 NEPHRON LANE, HUDSON, FL, 34667, US | 14134 NEPHRON LN, HUDSON, FL, 346676504, US | |||||||||||||||||||||||||
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| Phone | +1 727-266-1403 |
| Fax | 7274976784 |
| Phone | +1 727-863-5418 |
| Fax | 7278698626 |
Authorized person
| Name | SHAWN ERIC BARNETT |
| Role | CREDENTIALING AND COMPLIANCE MGR |
| Phone | 7278635418 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 24654 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NATIONAL KIDNEY PARTNERS 401(K) PLAN | 2023 | 593068073 | 2024-09-13 | NATIONAL KIDNEY PARTNERS | 111 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-13 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2000-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4146413940 |
| Plan sponsor’s address | 14134 NEPHRON LANE, HUDSON, FL, 34667 |
Signature of
| Role | Plan administrator |
| Date | 2024-10-14 |
| Name of individual signing | VANESSA URREGO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Shetye Kedar MD | Manager | 14134 Nephron Lane, Hudson, FL, 34667 |
| Paxton Lani KMD | Chief Executive Officer | 14134 Nephron Lane, Hudson, FL, 34667 |
| Brucculeri Michael MD | Manager | 14134 NEPHRON LANE, HUDSON, FL, 34467 |
| DiPaolo Marc MD | Comp | 14134 NEPHRON LANE, HUDSON, FL, 34467 |
| Mowen Kyle | IT | 14134 NEPHRON LANE, HUDSON, FL, 34467 |
| Mowen Kyle | Director | 14134 NEPHRON LANE, HUDSON, FL, 34467 |
| Shetye Kedar M.D. | Agent | 14134 NEPHRON LANE, HUDSON, FL, 34467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-07-31 | Shetye, Kedar, M.D. | - |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-07-31 |
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-09-01 |
| ANNUAL REPORT | 2022-07-26 |
| Florida Limited Liability | 2021-02-02 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
