ISD RENAL INC (NPI# 1104871573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104871573 |
| Entity Type | Organization |
| Organization Name | ISD RENAL INC |
| Other Organization Name | JACKSON SOUTHWEST DIALYSIS |
| Practice Address |
1828 Raymond Rd Jackson MS 39204 |
| Mailing Address |
5200 Virginia Way L & C Department Brentwood TN 37027-7569 |
| Practice Telephone | 6013739154 |
| Practice Fax Number | 6013730136 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2018-07-30 |
| Authorized Official Name | MR. 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 |
|---|---|---|---|
| MS | 00220062 | 05 |
| Other Name | Type Code |
|---|---|
| Jackson Southwest Dialysis | 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 |
1828 RAYMOND RD |
| City | JACKSON |
| State | MS |
| Zip Code | 39204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386991230 | Compassionate Hearts | Social Worker | 1828 Raymond Rd, Suite A, Jackson, MS 39204-4126 | 2012-08-10 |
| 1477695815 | C. David Finch, Jr., M.d. | Internal Medicine | 1828 Raymond Rd, Jackson, MS 39204-4126 | 2007-02-13 |
| 1598806895 | Charles David Finch Jr. | Emergency Medicine | 1828 Raymond Rd, Jackson, MS 39204-4126 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
| 1427593888 | Care First Home Care Agency, Inc | In Home Supportive Care | 931 Hwy 80 Suite 2 B-9, Jackson, MS 39204 | 2016-12-21 |
| 1134678808 | Yolonda Kinzie | Registered Nurse | 1134 Winter St., Jackson, MS 39204 | 2016-09-23 |
| 1578983938 | Seaneather Arline Mcgill | Nurse's Aide | 2024 Shady Lane Dr, Jackson, MS 39204 | 2014-04-23 |
| 1942591128 | Real Solutilons, LLC | Exclusive Provider Organization | 831 Hwy 80 W., Jackson, MS 39204 | 2011-04-22 |
| 1548405236 | Visions Physical Therapy | Specialist/Technologist | 4700 Robinson Rd, Jackson, MS 39204 | 2008-12-09 |
| 1588759393 | Donald H Butts | Specialist | 1920 Chadwick Drive, Suite 109, Jackson, MS 39204 | 2006-10-04 |
| 1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
| 1922117662 | Elgin Kenneth Walley | Dentist | 2174 Henry Hill Drive, Jackson, MS 39204 | 2006-08-29 |
| 1376555045 | Linda Nell Hunter | Nurse Practitioner | 1860 Chadwick Dr Ste 150a, Jackson, MS 39204 | 2006-08-12 |
| Find all providers in zip 39204 | ||||
| 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 |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1417481755 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 656 N State St, Jackson, MS 39202-3303 | 2017-04-13 |
| 1619274610 | Total Renal Care Inc | Clinic/Center | 46 Harts Bridge Road, Jackson, TN 38301-0000 | 2011-02-28 |
| 1770711509 | Fresenius Medical Care Kidney and Hypertension, LLC | Clinic/Center | 128 N Elm Ave, Jackson, MI 49202-3502 | 2009-07-01 |
| 1720220213 | Ara-jackson Dialysis LLC | Clinic/Center | 3 Acy Ave, Suite B, Jackson, OH 45640-9561 | 2009-03-30 |
| 1912166778 | Bio-medical Applications of Ohio Inc | Clinic/Center | 820 Veterans Dr, Jackson, OH 45640-2411 | 2008-06-06 |
| 1548489149 | Synergy Dialysis Associates, LLC | Clinic/Center | 500 Mccarty Ln, Jackson, OH 45640 | 2007-04-24 |
| 1245324045 | Rai Care Centers of Michigan I, LLC | Clinic/Center | 200 South East Ave., Jackson, MI 49201-2414 | 2006-10-03 |
| 1013019215 | Bio-medical Applications of Kentucky, Inc. | Clinic/Center | 1550 Highway 15 S Ste 30, Jackson, KY 41339-9221 | 2006-09-01 |
| 1518079359 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 2995 Race St, Jackson, LA 70748-5839 | 2006-08-31 |
| Find all providers in JACKSON | ||||
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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.