KINGSTON DIALYSIS LLC (NPI# 1164890604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164890604 |
| Entity Type | Organization |
| Organization Name | KINGSTON DIALYSIS LLC |
| Other Organization Name | MILE HIGH HOME DIALYSIS |
| Practice Address |
1750 Pierce St Ste A Lakewood CO 80214 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 3032320939 |
| Practice Fax Number | 3032746096 |
| Mailing Telephone | 6153416264 |
| Mailing Fax Number | 8002972925 |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2020-08-19 |
| 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 |
12R950 | CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 36032395 | 05 |
| Other Name | Type Code |
|---|---|
| Mile High Home Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| 1164899670 | Kingston Dialysis LLC | Clinic/Center | 9950 W 80th Ave Ste 25, Arvada, CO 80005 | 2015-09-01 |
| 1679940324 | Kingston Dialysis LLC | Clinic/Center | 1750 Pierce St Ste C, Lakewood, CO 80214-1434 | 2015-08-28 |
| 1740657402 | Kingston Dialysis LLC | Clinic/Center | 1715 Iron Horse Dr Ste 170, Longmont, CO 80501 | 2015-08-28 |
| 1922475672 | Kingston Dialysis LLC | Clinic/Center | 1057 S Wadsworth Blvd Ste 100, Lakewood, CO 80226 | 2015-08-28 |
| 1386012268 | Kingston Dialysis LLC | Clinic/Center | 8800 Fox Dr, Thornton, CO 80260 | 2015-09-09 |
| Street Address |
1750 PIERCE ST STE A |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982266128 | Audra Perez | Social Worker | 1750 Pierce Street Suite C, Lakewood, CO 80214 | 2019-07-08 |
| 1508347758 | Robin Noel Mackin | Speech-Language Pathologist | 2401 Lamar Street, Edgewater, CO 80214 | 2018-08-26 |
| 1932636065 | Tamika Thomas | Counselor | 950 Wadsworth Blvd Ste 203, Lakewood, CO 80214 | 2017-05-19 |
| 1902353568 | Holly Carpenter | Counselor | 1410 Vance St, Lakewood, CO 80214 | 2016-09-01 |
| 1285094672 | Danijela Jankovic | Dentist | 7611 W.colfax Avenue, Suite D, Lakewood, CO 80214 | 2016-02-29 |
| 1053784207 | Dale Kim | Dentist | 1921 Sheridan Blvd Unit F, Edgewater, CO 80214 | 2015-11-10 |
| 1558747923 | Hv Lakewood | Optometrist | 6695 W. Colfax Ave., Lakewood, CO 80214 | 2015-08-07 |
| 1265879498 | Diana M Arvizo | Occupational Therapy Assistant | 1685 Eaton St., Lakewood, CO 80214 | 2013-05-29 |
| 1528332731 | Jennifer Anderson | Physical Therapist | 5354 W 25th Ave, Edgewater, CO 80214 | 2012-03-06 |
| 1538462452 | Justin S. Braegger | Chiropractor | 2532 Sheridan Blvd, Denver, CO 80214 | 2010-12-15 |
| Find all providers in zip 80214 | ||||
| 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 |
|---|---|---|---|---|
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1679940324 | Kingston Dialysis LLC | Clinic/Center | 1750 Pierce St Ste C, Lakewood, CO 80214-1434 | 2015-08-28 |
| 1922475672 | Kingston Dialysis LLC | Clinic/Center | 1057 S Wadsworth Blvd Ste 100, Lakewood, CO 80226 | 2015-08-28 |
| 1588972012 | Kidney Center of Bear Creek LLC | Clinic/Center | 11058 W Jewell Ave, Lakewood, CO 80232-6139 | 2010-09-17 |
| 1831420462 | Total Renal Care Inc | Clinic/Center | 14050 Madison Ave, Lakewood, OH 44107-4530 | 2010-01-21 |
| 1831388107 | Kidney Center of Lakewood LLC | Clinic/Center | 6166 W Alameda Ave, Lakewood, CO 80226-3539 | 2007-10-23 |
| 1124122908 | Lakewood Dialysis Services, LLC | Clinic/Center | 1328 River Ave, #16, Lakewood, NJ 08701-5645 | 2006-09-12 |
| 1003870130 | Total Renal Care Inc | Clinic/Center | 5919 Lakewood Towne Center Blvd Sw Ste A, Lakewood, WA 98499-6513 | 2006-04-14 |
| 1285693002 | Total Renal Care Inc | Clinic/Center | 4611 Silva St, Lakewood, CA 90712-2512 | 2006-03-21 |
| 1295703585 | Total Renal Care Inc | Clinic/Center | 1057 S Wadsworth Blvd, Ste 100, Lakewood, CO 80226-4360 | 2006-03-10 |
| Find all providers in LAKEWOOD | ||||
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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.