NORTHWEST JACKSONVILLE DIALYSIS CENTER LLC (NPI# 1619120698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619120698 |
| Entity Type | Organization |
| Organization Name | NORTHWEST JACKSONVILLE DIALYSIS CENTER LLC |
| Other Organization Name | ARA NORTH JACKSONVILLE |
| Practice Address |
1725 Oakhurst Avenue Suite 100 Jacksonville FL 32208-3282 |
| Practice Telephone | 9047662279 |
| Practice Fax Number | 9049247568 |
| Mailing Telephone | 9047662279 |
| Mailing Fax Number | 9049247568 |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2020-03-13 |
| Authorized Official Name | SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY) |
| Authorized Official Telephone | 9789223080 |
| 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 |
|---|---|---|---|
| FL | 000987500 | 05 |
| Other Name | Type Code |
|---|---|
| ARA North Jacksonville | Doing Business As Name - Organization |
| Street Address |
1725 OAKHURST AVENUE SUITE 100 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32208-3282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845379 | Lameka Williams | Adult Companion | 6854 Cartier Cir, Jacksonville, FL 32208 | 2020-09-15 |
| 1386173722 | Danielle Mathews | Home Health | 6824 Barberie St., Jacksonville, FL 32208 | 2017-06-08 |
| 1063957520 | Crystal Tramaine Simmons | Licensed Practical Nurse | 3190 Sedona Trl, Jacksonville, FL 32208 | 2016-12-19 |
| 1508316084 | Melissa Angel | Emergency Medical Technician, Basic | 3701 Winton Drive, Jacksonville, FL 32208 | 2016-10-10 |
| 1093176828 | Stephanie Fears | Chore Provider | 5910 Droad St, Jacksonville, FL 32208 | 2016-03-07 |
| 1841676558 | Elizabeth Ann Miller | Social Worker | 1255 Lila Ave, Jacksonville, FL 32208 | 2015-08-04 |
| 1861877698 | Sara Castro | Counselor | 1110 Edgewood Ave West, Jacksonville, FL 32208 | 2015-07-22 |
| 1215352703 | Luther Quarles Iv | Family Medicine | 1760 Edgewood Ave W Ste A&b, Jacksonville, FL 32208 | 2014-02-20 |
| 1356776348 | Top of The Line Mobile Service | Durable Medical Equipment & Medical Supplies | 2252 4th Avenue, Jacksonville, FL 32208 | 2013-09-09 |
| 1437419124 | Carmelita Patrice Rowell | Specialist | 2255 Soutel Dr, Jacksonville, FL 32208 | 2012-05-29 |
| Find all providers in zip 32208 | ||||
| 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 |
|---|---|---|---|---|
| 1487274734 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 2777 University Blvd W Ste 39, Jacksonville, FL 32217-2143 | 2020-04-16 |
| 1063980969 | Total Renal Care, Inc | Clinic/Center | 8021 Philips Hwy Ste 15, Jacksonville, FL 32256-4452 | 2018-11-08 |
| 1720538556 | Total Renal Care Inc | Clinic/Center | 5276 Blanding Blvd Ste 26, Jacksonville, FL 32210 | 2016-10-05 |
| 1588017784 | Lake Gray Dialysis Center LLC | Clinic/Center | 6196 Lake Gray Blvd, Suite 112, Jacksonville, FL 32244-7503 | 2016-07-22 |
| 1891143103 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 1211 St. Johns Bluff Rd North, Jacksonville, FL 32225 | 2016-05-26 |
| 1457725806 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 3107 Edgewood Ave West, Jacksonville, FL 32209-2209 | 2015-11-23 |
| 1912307596 | Total Renal Care of North Carolina LLC | Clinic/Center | 111 Yopp Road, Jacksonville, NC 28540-3509 | 2014-09-02 |
| 1497186084 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 5607 Normandy Blvd, Jacksonville, FL 32205-6248 | 2013-12-06 |
| 1144653270 | Nxstage Jacksonville, LLC | Clinic/Center | 2777 University Blvd W, Suite 39, Jacksonville, FL 32217-2176 | 2013-08-13 |
| 1114284494 | Kidney Kare of Jacksonville Fl, Inc. | Clinic/Center | 4168 Southpoint Pkwy, Jacksonville, FL 32216-0966 | 2012-04-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32208 |
Please comment or provide details below to improve the information on NORTHWEST JACKSONVILLE DIALYSIS CENTER LLC.
| 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.