DIERKS DIALYSIS LLC (NPI# 1619442639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619442639 |
| Entity Type | Organization |
| Organization Name | DIERKS DIALYSIS LLC |
| Other Organization Name | HARTFORD DOWNTOWN DIALYSIS |
| Practice Address |
80 Seymour St Hartford CT 06106-3300 |
| Mailing Address |
5200 Virginia Way L & C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 8602442108 |
| Practice Fax Number | 8602442133 |
| Mailing Telephone | 6153204214 |
| Mailing Fax Number | 8669443352 |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2020-04-03 |
| Authorized Official Name | JOHN D 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 |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008085529 | 05 |
| Other Name | Type Code |
|---|---|
| Hartford Downtown Dialysis | Doing Business As Name - Organization |
| Street Address |
80 SEYMOUR ST |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106-3300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942207394 | Avinash Prasad | Psychiatry & Neurology | 80 Seymour St, Hartford Hospital Neurology Dept, Hartford, CT 06102-8000 | 2005-06-30 |
| 1215535935 | Lataya Hewitt | Nurse Practitioner | 80 Seymour St, Hartford, CT 06106-3315 | 2020-10-14 |
| 1629685938 | Nicole Martina | Nurse Practitioner | 80 Seymour St, Hartford, CT 06106-3315 | 2020-09-30 |
| 1477168011 | Cassidy Goodwin | Nurse Practitioner | 80 Seymour St, Hartford, CT 06102-8000 | 2020-09-10 |
| 1215541933 | Molly Zarnick | Speech-Language Pathologist | 80 Seymour St, Hartford, CT 06106-3300 | 2020-09-01 |
| 1306457320 | Taylor Merrick | Physician Assistant | 80 Seymour St, Hartford, CT 06102-8000 | 2020-08-13 |
| 1538770474 | Carlyn Esposito | Registered Nurse | 80 Seymour St, Hartford, CT 06106-3315 | 2020-08-13 |
| 1679184121 | Kimberly M Davis | Nurse Anesthetist, Certified Registered | 80 Seymour St, Hartford, CT 06106-3315 | 2020-08-10 |
| 1679182109 | Elsayed Elsayed Hassan Ibrahim | Student in an Organized Health Care Education/Training Program | 80 Seymour St, Hartford, CT 06102-8000 | 2020-07-30 |
| 1780292615 | Jordan Steven Totaro | Student in an Organized Health Care Education/Training Program | 80 Seymour St, Hartford, CT 06106-3315 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| 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 |
|---|---|---|---|---|
| 1578106951 | Connecticut Children's Medical Center | Clinic/Center | 282 Washington St, Hartford, CT 06106-3322 | 2019-10-18 |
| 1639188386 | Bio-medical Applications of Connecticut, Inc. | Clinic/Center | 3580 Main St, Hartford, CT 06120-1121 | 2006-08-05 |
| 1356317192 | Dva Renal Healthcare Inc | Clinic/Center | 675 Tower Ave, Fl 2, Hartford, CT 06112-1260 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750939963 | Total Renal Care Inc | Clinic/Center | 7 Cambridge Dr Ste 105, Trumbull, CT 06611-4763 | 2019-08-30 |
| 1255839494 | Total Renal Care Inc | Clinic/Center | 425 Hawley Ln, Stratford, CT 06614-1514 | 2018-01-23 |
| 1366829343 | Wallingford Dialysis Care LLC | Clinic/Center | 720 N Main Street Ext, Suites 1 - 3, Wallingford, CT 06492-2417 | 2015-04-29 |
| 1417345828 | Tross Dialysis LLC | Clinic/Center | 164 Mount Pleasant Rd, Newtown, CT 06470-1408 | 2015-01-07 |
| 1184031437 | Argyle Dialysis LLC | Clinic/Center | 51 Palomba Dr, Enfield, CT 06082-3801 | 2014-07-18 |
| 1578838405 | Riverside Radiology Consultants, LLC | Clinic/Center | 65 Harvard Ave, Stamford, CT 06902-5564 | 2012-03-10 |
| 1952616633 | Total Renal Care Inc | Clinic/Center | 445e Willard Ave, Newington, CT 06111-2318 | 2010-08-18 |
| 1013228816 | Bio-medical Applications of Connecticut, Inc. | Clinic/Center | 725 Park Ave, Bloomfield, CT 06002-2402 | 2010-06-25 |
| 1386896587 | St. Raphael Dialysis Center Partnership | Clinic/Center | 266 State St, North Haven, CT 06473-2154 | 2008-10-21 |
| 1558524512 | Total Renal Care Inc | Clinic/Center | 427 Stillson Rd, Fairfield, CT 06824-3153 | 2008-07-09 |
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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.