ISD RENAL INC (NPI# 1386699445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386699445 |
| Entity Type | Organization |
| Organization Name | ISD RENAL INC |
| Other Organization Name | SOUTH ANTHONY DIALYSIS |
| Practice Address |
7017 S Anthony Blvd Fort Wayne IN 46816-2016 |
| Mailing Address |
5200 Virginia Way Licensure & Certification Brentwood TN 37027-7569 |
| Practice Telephone | 2604472220 |
| Practice Fax Number | 2604472044 |
| Mailing Telephone | 6153416374 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2011-11-03 |
| Authorized Official Name | MR. JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2532721916 |
| 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 |
| Other Name | Type Code |
|---|---|
| South Anthony 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 |
7017 S ANTHONY BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46816-2016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841769270 | Brian Bernard Conaway | Occupational Therapist | 7125 S Hanna St, Fort Wayne, IN 46816 | 2018-11-14 |
| 1073006938 | Fort Wayne Aal Lp | Assisted Living Facility | 7125 S Hanna Street, Fort Wayne, IN 46816 | 2018-06-14 |
| 1811282064 | Connisha Sanders | Occupational Therapy Assistant | 8309, Bridgeway Cir Apt 3a, Fort Wayne, IN 46816 | 2011-06-16 |
| 1144239609 | James J Bohlin | Dentist | 7524 South Anthony Blvd., Fort Wayne, IN 46816 | 2006-08-05 |
| 1578594537 | K Mart Corp | Pharmacy | 7530 S Anthony Blvd, Fort Wayne, IN 46816 | 2006-07-06 |
| 1720540503 | Jill Ann Woodward | Occupational Therapy Assistant | 7125 S Hanna St, Fort Wayne, IN 46816 | 2019-04-02 |
| 1639163884 | Patrice C Ellingson | Optometrist | 1515 E Paulding Rd, Fort Wayne, IN 46816 | 2005-09-02 |
| 1114140134 | Jon D. Ingleman | Dentist | 223 E Tillman Rd, Fort Wayne, IN 46816-1016 | 2007-04-10 |
| 1538189063 | Yoder/rahrig Family Dentistry | Dentist | 333 E Tillman Rd, Fort Wayne, IN 46816-1017 | 2006-07-20 |
| 1619997137 | Gerald J. Rahrig | Dentist | 333 E Tillman Rd, Fort Wayne, IN 46816-1017 | 2006-07-20 |
| Find all providers in zip 46816 | ||||
| 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 |
| 1093012544 | Bridges Dialysis LLC | Clinic/Center | 1833 Magnavox Way, Fort Wayne, IN 46804-1539 | 2011-02-18 |
| 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 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46816 |
Please comment or provide details below to improve the information on ISD RENAL 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.