AFTON NEPHROLOGY ASSOCIATES (NPI# 1538265335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538265335 |
| Entity Type | Organization |
| Organization Name | AFTON NEPHROLOGY ASSOCIATES |
| Other Organization Name | STATE FAIR DIALYSIS CENTER |
| Practice Address |
19800 Woodward Ave Detroit MI 48203-5102 |
| Practice Telephone | 3138938610 |
| Mailing Telephone | 3138938610 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | DR. RACHEL DONALDSON (CEO) |
| Authorized Official Telephone | 3138938610 |
| Authorized Official Credential | M.D. |
| 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 |
4301406139 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS | D9411 | 01 |
| MI | MCARE | 14040 | 01 |
| MI | BCBS | 08999 | 01 |
| MI | CAPE HEALTH PLAN | 9367 | 01 |
| MI | BCN | 08999 | 01 |
| MI | OMNICARE | 49441 | 01 |
| Other Name | Type Code |
|---|---|
| State Fair Dialysis Center | Doing Business As Name - Organization |
| Street Address |
19800 WOODWARD AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48203-5102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285942409 | Total Renal Care Inc | Clinic/Center | 19800 Woodward Ave, Detroit, MI 48203-5102 | 2010-09-22 |
| 1528164316 | Rachel Donaldson | Internal Medicine | 19800 Woodward Ave, Detroit, MI 48203-5102 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992355135 | James Calloway | Peer Specialist | 1211 E Mcnichols, Detroit, MI 48203 | 2019-09-19 |
| 1851868582 | Community Veterans Services Inc | Counselor | 163 Tennyson, Highland Park, MI 48203 | 2018-10-31 |
| 1346601838 | Rainbow Center of Michigan | Health Maintenance Organization | 12501 Hamilton Ave., Highland Park, MI 48203 | 2016-03-11 |
| 1134502354 | Minds Moving In New Directions Inc | Community/Behavioral Health | 62 Massachusetts St, Highland Park, MI 48203 | 2015-07-07 |
| 1811312937 | Brea Holloway | Home Health | 20249 Yacama Rd, Detroit, MI 48203 | 2014-02-26 |
| 1770821795 | St John Providence Health Systems | Community/Behavioral Health | 1150 Lantz St, Detroit, MI 48203 | 2013-01-25 |
| 1871845412 | Waneta Darcell Dickerson | Social Worker | 169 W. Buena Vista, Highlandpark, MI 48203 | 2012-10-05 |
| 1629331939 | Maureen Connolly | Pediatrics | 77 Victor St, Highland Park, MI 48203 | 2012-06-21 |
| 1578850251 | Detroit Recovery Project | Community/Behavioral Health | 1121 East Mc Nichols, Detroit, MI 48203 | 2011-07-01 |
| 1265728414 | Barbara Suzanne Tyson | Home Health | 301 Glendale St, Apt B8, Highland Park, MI 48203 | 2011-06-27 |
| Find all providers in zip 48203 | ||||
| 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 |
|---|---|---|---|---|
| 1740789536 | Plover Dialysis LLC | Clinic/Center | 13945 Wyoming St, Detroit, MI 48238-2333 | 2018-02-07 |
| 1295192979 | Detroit Kidney Center LLC | Clinic/Center | 13437 Schaefer Hwy, Detroit, MI 48227-3538 | 2016-01-26 |
| 1245533371 | Chakudaku, Inc. | Clinic/Center | 1401 Rosa Parks Blvd, Detroit, MI 48216-1953 | 2010-12-11 |
| 1770816498 | Advanced Dialysis of Greater Detroit LLC | Clinic/Center | 18600 James Couzens Hwy, Detroit, MI 48235-2509 | 2009-09-14 |
| 1528294691 | Nephrology Center of Detroit LLC | Clinic/Center | 20001 Livernois Ave Ste 500, Detroit, MI 48221-4123 | 2009-06-03 |
| 1730227646 | Grosse Pointe Dialysis LLC | Clinic/Center | 18000 E Warren Ave, Ste 100, Detroit, MI 48224-1336 | 2007-02-02 |
| 1730286014 | Optimal Care Dialysis | Clinic/Center | 18600 James Couzens Fwy, Detroit, MI 48235-2509 | 2006-09-20 |
| 1871608612 | Bio-medical Applications of Michigan, Inc. | Clinic/Center | 18430 Livernois Ave, Detroit, MI 48221-3295 | 2006-08-20 |
| 1093820839 | Bio-medical Applications of Michigan, Inc. | Clinic/Center | 18944 Grand River Ave, Detroit, MI 48223-2270 | 2006-08-20 |
| 1043325889 | Bio-medical Applications of Michigan, Inc. | Clinic/Center | 7733 E Jefferson Ave Ste 120, Detroit, MI 48214-3707 | 2006-08-20 |
| Find all providers in DETROIT | ||||
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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.