ISD RENAL INC (NPI# 1063923753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063923753 |
Entity Type | Organization |
Organization Name | ISD RENAL INC |
Other Organization Name | ROLLA HOME TRAINING |
Practice Address |
1702 E 10th St Ste C Rolla MO 65401-4600 |
Mailing Address |
5200 Virginia Way L & C Department Brentwood TN 37027-7569 |
Practice Telephone | 5734582013 |
Practice Fax Number | 5734582094 |
Mailing Telephone | 6153416264 |
Mailing Fax Number | 8002972925 |
Enumeration Date | 2017-10-20 |
Last Update Date | 2020-04-08 |
Authorized Official Name | JOHN 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 |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 500060490 | 05 |
Other Name | Type Code |
---|---|
Rolla Home Training | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295344307 | Isd Renal Inc | Clinic/Center | 1930 S Broad St Unit 7, Philadelphia, PA 19145-2328 | 2020-07-24 |
1225647332 | Isd Renal Inc | Clinic/Center | 230 N Broad St Bldg 12th, Philadelphia, PA 19102-1121 | 2020-07-24 |
1336758549 | Isd Renal Inc | Clinic/Center | 1300 W Lehigh Ave Ste 106, Philadelphia, PA 19132-2764 | 2020-07-24 |
1538793773 | Isd Renal Inc | Clinic/Center | 2317 Memorial Pkwy Sw Ste 105, Huntsville, AL 35801-5623 | 2020-02-26 |
1821646035 | Isd Renal Inc | Clinic/Center | 262 Broad St, Newark, NJ 07104-3809 | 2019-08-30 |
1245891670 | Isd Renal Inc | Clinic/Center | 100 W Forest Ave Ste G, Englewood, NJ 07631-4033 | 2019-06-26 |
1235795204 | Isd Renal Inc | Clinic/Center | 4952 Parkside Ave, Philadelphia, PA 19131 | 2019-05-15 |
1003390469 | Isd Renal Inc | Clinic/Center | 1843 Foreman Dr Ste 201, Cookeville, TN 38501-5933 | 2018-09-21 |
1174006662 | Isd Renal Inc | Clinic/Center | 2636 W Michigan St, Indianapolis, IN 46222-3727 | 2018-09-11 |
1619459682 | Isd Renal Inc | Clinic/Center | 620 Mall Blvd Ste E, Dyersburg, TN 38024-1649 | 2018-09-05 |
Street Address |
1702 E 10TH ST STE C |
City | ROLLA |
State | MO |
Zip Code | 65401-4600 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
Find all providers in zip 65401 |
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 |
---|---|---|---|---|
1427019025 | Dva Renal Healthcare Inc | Clinic/Center | 1503 E 10th St, Rolla, MO 65401-3696 | 2006-03-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336748110 | Westbrook Dialysis, LLC | Clinic/Center | 140 West Drive, Cape Girardeau, MO 63701 | 2020-10-22 |
1902415284 | Fresenius Medical Care Creve Coeur Home Therapies, LLC | Clinic/Center | 450 N New Ballas Rd Ste 170, Creve Coeur, MO 63141-6835 | 2020-07-23 |
1730716085 | Fresenius Medical Care Creve Coeur, LLC | Clinic/Center | 450 North New Bassas Road, Suite 180, Creve Coeur, MO 63141-6835 | 2020-03-26 |
1285109041 | Branson Kidney Center LLC | Clinic/Center | 17829 Bus 13, Branson West, MO 65737 | 2018-10-09 |
1790271864 | Dialysis Clinic Inc | Clinic/Center | 3101 W Broadway Ste 115, Columbia, MO 65203-0496 | 2018-07-02 |
1033602990 | Lantell Dialysis LLC | Clinic/Center | 8608 E 63rd St, Kansas City, MO 64133-4725 | 2018-06-14 |
1851892731 | Sparda Dialysis LLC | Clinic/Center | 40 Walters Pl, House Springs, MO 63051-1491 | 2018-02-26 |
1063923977 | Total Renal Care Inc | Clinic/Center | 802 Jules St, St Joseph, MO 64501-1944 | 2017-10-18 |
1942710991 | Washington University | Clinic/Center | 272 Mayfair Plaza Shopping Ctr, Florissant, MO 63033-8009 | 2017-10-04 |
1376077123 | Isd Renal, Inc. | Clinic/Center | 14001 New Halls Ferry Rd Ste 133, Florissant, MO 63033-2708 | 2017-04-19 |
Find all providers with the same taxonomy |
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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.