JEFFERSON COUNTY DIALYSIS INC (NPI# 1285746180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285746180 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COUNTY DIALYSIS INC |
| Other Organization Name | MONTICELLO DIALYSIS |
| Practice Address |
774 Jordan Dr Monticello AR 71655-5718 |
| Practice Telephone | 8703673100 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-03-15 |
| Authorized Official Name | MARK FAWCETT (TREASURER) |
| Authorized Official Telephone | 7816999000 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
| 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 |
| Other Name | Type Code |
|---|---|
| MONTICELLO DIALYSIS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467564369 | Jefferson County Dialysis Inc | Clinic/Center | 2910 Market Street, Suite 19, Pine Bluff, AR 71601-9806 | 2006-08-31 |
| Street Address |
774 JORDAN DR |
| City | MONTICELLO |
| State | AR |
| Zip Code | 71655-5718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462712 | Ashley Leanna Huitt | Nurse Practitioner | Drew Memorial Health System, 778 Scogin Drive, Monticello, AR 71655 | 2019-11-19 |
| 1043716525 | Mmc Rural Health Clinics, Pllc | Clinic/Center | 733 Roberts Drive, Monticello, AR 71655 | 2018-04-03 |
| 1760991640 | Kristen Leigh Harvey | Registered Nurse | 162 University Heights Drive, Monticello, AR 71655 | 2017-09-24 |
| 1124578075 | Morgan Family Dentistry, Pllc | Dentist | 501 Hwy 425 South, Monticello, AR 71655 | 2016-10-04 |
| 1770039752 | Jesse Bone | Nurse Practitioner | 766 Hl Ross Drive, Monticello, AR 71655 | 2016-08-30 |
| 1487050076 | Sara Tucker | Speech-Language Pathologist | 178 W. College Street, Monticello, AR 71655 | 2014-11-10 |
| 1164859203 | Dustin Clint Eubanks | Chiropractor | 604 A West Bolling Street, Monticello, AR 71655 | 2013-10-03 |
| 1194009431 | Rebecca Shea Woodall | Social Worker | 600 Highway 425 North, Suite B, Monticello, AR 71655 | 2011-10-05 |
| 1568744522 | Britney Leigh Box | Occupational Therapist | 178 W College St, Monticello, AR 71655 | 2011-09-15 |
| 1740415611 | Julia Danielle Nicholson | Family Medicine | 906 Roberts Drive, Monticello, AR 71655 | 2009-05-21 |
| Find all providers in zip 71655 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| 1003915455 | Greater Lafayette Health Services | Clinic/Center | 1017 O Connor Blvd, Monticello, IN 47960-1600 | 2006-09-22 |
| 1508802968 | Knickerbocker Dialysis Inc | Clinic/Center | 139 Forestburgh Rd, Monticello, NY 12701-2348 | 2006-06-22 |
| 1245287358 | Nra Monticello Georgia LLC | Clinic/Center | 1393 Funderburg Dr, Monticello, GA 31064-6818 | 2006-05-27 |
| 1497141576 | Dsi Macon, LLC | Clinic/Center | 1393 Funderburg Dr, Monticello, GA 31064-6818 | 2015-04-15 |
| 1518057918 | Liberty Dialysis - Lafayette LLC | Clinic/Center | 810 S 6th St, Monticello, IN 47960-8201 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092597 | Fort Smith Regional Dialysis Center, LLC | Clinic/Center | 256 Northridge Drive E, Van Buren, AR 72956 | 2020-08-06 |
| 1073010518 | Toltec Dialysis LLC | Clinic/Center | 2630 Donaghey Ave, Conway, AR 72032-0000 | 2018-04-11 |
| 1588102610 | Matheson Dialysis LLC | Clinic/Center | 9022 Landers Rd Ste E, North Little Rock, AR 72117-1599 | 2017-02-09 |
| 1871031211 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 115 E Peddicord St, Dermott, AR 71638-2314 | 2017-02-06 |
| 1821455494 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 505 Saint Mary St, Lake Village, AR 71653-1722 | 2016-01-27 |
| 1912399601 | Ozark Dialysis LLC | Clinic/Center | 404 Camp Rd, Pocahontas, AR 72455-1487 | 2015-03-04 |
| 1447640917 | Fidelity Home Dialysis Corporation | Clinic/Center | 9421 W Markham St, Little Rock, AR 72205-2240 | 2015-02-04 |
| 1386053296 | Arkansas Staff Assisted Hemodialysis,inc | Clinic/Center | 321 Terry Pond Cv, White Hall, AR 71602-8212 | 2014-08-05 |
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 71655 |
Please comment or provide details below to improve the information on JEFFERSON COUNTY DIALYSIS INC.
| 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.