BRIDGES DIALYSIS LLC (NPI# 1093012544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093012544 |
| Entity Type | Organization |
| Organization Name | BRIDGES DIALYSIS LLC |
| Other Organization Name | APPLESEED DIALYSIS |
| Practice Address |
1833 Magnavox Way Fort Wayne IN 46804-1539 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 2604321036 |
| Practice Fax Number | 2604322085 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2020-01-14 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| 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 |
|---|---|---|---|
| IN | 201048220 A | 05 |
| Other Name | Type Code |
|---|---|
| Appleseed Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558635276 | Bridges Dialysis LLC | Clinic/Center | 3233 E Coliseum Blvd, Fort Wayne, IN 46805-1561 | 2012-02-27 |
| 1003119876 | Bridges Dialysis LLC | Clinic/Center | 302 E Pettit Ave, Fort Wayne, IN 46806-3007 | 2010-12-16 |
| 1366745630 | Bridges Dialysis LLC | Clinic/Center | 4916 Illinois Rd, Suite 118, Fort Wayne, IN 46804-5116 | 2010-12-08 |
| Street Address |
1833 MAGNAVOX WAY |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-1539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| 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 |
|---|---|---|---|---|
| 1558716019 | Duston Dialysis, LLC | Clinic/Center | 415 E Dupont Rd, Fort Wayne, IN 46825-2051 | 2016-05-03 |
| 1659796233 | Randolph Dialysis LLC | Clinic/Center | 6721 Old Trail Rd, Ste 100, Fort Wayne, IN 46809-2655 | 2014-02-19 |
| 1558635276 | Bridges Dialysis LLC | Clinic/Center | 3233 E Coliseum Blvd, Fort Wayne, IN 46805-1561 | 2012-02-27 |
| 1003119876 | Bridges Dialysis LLC | Clinic/Center | 302 E Pettit Ave, Fort Wayne, IN 46806-3007 | 2010-12-16 |
| 1366745630 | Bridges Dialysis LLC | Clinic/Center | 4916 Illinois Rd, Suite 118, Fort Wayne, IN 46804-5116 | 2010-12-08 |
| 1770698524 | Maumee Dialysis Services, LLC | Clinic/Center | 10204 Dupont Circle Dr E, Fort Wayne, IN 46825-1611 | 2006-08-20 |
| 1174579551 | Isd Renal Inc | Clinic/Center | 3909 Lake Ave, Fort Wayne, IN 46805-5545 | 2006-05-26 |
| 1992751556 | Isd Renal Inc | Clinic/Center | 1940 Bluffton Rd, Fort Wayne, IN 46809-1307 | 2006-05-25 |
| 1639124886 | Dsi Renal Inc | Clinic/Center | 2414 Lake Ave, Fort Wayne, IN 46805-5406 | 2006-05-24 |
| 1386699445 | Isd Renal Inc | Clinic/Center | 7017 S Anthony Blvd, Fort Wayne, IN 46816-2016 | 2006-05-24 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on BRIDGES DIALYSIS 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.