CANYONLANDS DIALYSIS LLC (NPI# 1669631297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669631297 |
| Entity Type | Organization |
| Organization Name | CANYONLANDS DIALYSIS LLC |
| Other Organization Name | LEESBURG VIRGINIA DIALYSIS |
| Practice Address |
224 Cornwall St Nw Leesburg VA 20176-2701 |
| Mailing Address |
5200 Virginia Way Ste 400 L&c Brentwood TN 37027-7569 |
| Practice Telephone | 5712581362 |
| Practice Fax Number | 5712581342 |
| Mailing Telephone | 6153204521 |
| Mailing Fax Number | 8665942894 |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-11-25 |
| Authorized Official Name | JIM HILGER (VICE PRESIDENT) |
| Authorized Official Telephone | 2533821919 |
| 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 |
|---|---|---|---|
| VA | 1669631297 | 05 |
| Other Name | Type Code |
|---|---|
| Leesburg Virginia Dialysis | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Canyonlands Dialysis LLC | 601 Hawaii St, El Segundo, California 90245 |
| Street Address |
224 CORNWALL ST NW |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-2701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405662 | Dolores Steinglass | Registered Nurse | 224 Cornwall St Nw, Leesburg, VA 20176-2701 | 2005-05-27 |
| 1932506821 | Orthotic Prosthetic Center, Inc. | Prosthetic/Orthotic Supplier | 224 Cornwall St Nw, Cornwall Pavilion Building 224-d Suite 200b, Leesburg, VA 20176-2701 | 2014-11-21 |
| 1811204050 | Inova Physician Partners, Inc. - Specialists | Orthopaedic Surgery | 224 Cornwall St Nw, Leesburg, VA 20176-2701 | 2010-09-09 |
| 1326203704 | Sleepmed Therapies Inc | Durable Medical Equipment & Medical Supplies | 224 Cornwall St Nw, Suite 101, Leesburg, VA 20176-2701 | 2008-07-24 |
| 1073783759 | Fairfax Radiological Consultants PC | Specialist | 224 Cornwall St Nw, Leesburg, VA 20176-2701 | 2008-03-10 |
| 1568649424 | Fairfax Radiological Consultants PC | Specialist | 224 Cornwall St Nw, Leesburg, VA 20176-2701 | 2008-01-23 |
| 1245370550 | Lisa Marie Boris | Nurse Practitioner | 224 Cornwall St Nw, Leesburg, VA 20176-2701 | 2007-02-07 |
| 1285786228 | Inova Health Care Services | Psychiatric Unit | 224 Cornwall St Nw, Leesburg, VA 20176-2701 | 2007-01-18 |
| 1457409633 | Page Moss Fletcher Md PC | Psychiatry & Neurology | 224 Cornwall St Nw, Leesburg, VA 20176-2701 | 2007-01-06 |
| 1184611675 | Debra D Dever | Registered Nurse | 224 Cornwall St Nw, A, Leesburg, VA 20176-2701 | 2005-09-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
| 1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
| 1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
| 1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
| 1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
| 1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
| 1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
| 1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| Find all providers in zip 20176 | ||||
| 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 |
|---|---|---|---|---|
| 1447889399 | Legacy Dialysis of Virginia | Clinic/Center | 211 Gibson St Nw Ste 209, Leesburg, VA 20176-2115 | 2020-04-03 |
| 1851744247 | Dialysis Care Center Leesburg LLC | Clinic/Center | 600 W North Blvd Ste B, Leesburg, FL 34748-5000 | 2016-07-20 |
| 1205872173 | Total Renal Care Inc | Clinic/Center | 401 E North Blvd, Leesburg, FL 34748-5262 | 2006-06-21 |
| 1982671004 | Renal Treatment Centers Southeast Lp | Clinic/Center | 8425 Us Highway 441, Ste 104, Leesburg, FL 34788-4038 | 2006-03-07 |
| 1013457720 | Pure Life Renal of Lansdowne, LLC | Clinic/Center | 19490 Sandridge Way, Suite 140, Leesburg, VA 20176-3465 | 2017-02-28 |
| 1588108104 | Dialysis Clinic Inc | Clinic/Center | 210 Park St, Leesburg, GA 31763-5192 | 2016-12-16 |
| 1295078277 | Total Renal Care Inc | Clinic/Center | 44084 Riverside Pkwy, Suite 100, Leesburg, VA 20176-5102 | 2013-03-28 |
| 1538470653 | Total Renal Care Inc | Clinic/Center | 224d Cornwall St Nw, Ste 100, Leesburg, VA 20176-2700 | 2010-06-23 |
| 1962479386 | Renal Treatment Centers Southeast Lp | Clinic/Center | 211 N 1st St, Leesburg, FL 34748-5150 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497363253 | Fresenius Medical Care Kempsville Home, LLC | Clinic/Center | 6161 Kempsville Cir Ste B, Norfolk, VA 23502-3932 | 2020-07-17 |
| 1760004360 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 7525 Tidewater Dr Ste 37, Norfolk, VA 23505-3700 | 2020-05-18 |
| 1871113746 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 165 Market St Ste 6, Onancock, VA 23417-4233 | 2020-04-21 |
| 1457907917 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 570 Westgate Shopping Ctr, Bedford, VA 24523-2643 | 2019-08-12 |
| 1306492848 | Renal Treatment Centers- Mid-atlantic, Inc. | Clinic/Center | 145 Holt Garrison Pkwy Ste 340, Danville, VA 24540-5956 | 2019-08-12 |
| 1043873664 | Branbur Dialysis LLC | Clinic/Center | 4650 Puddledock Rd, Prince George, VA 23875-1235 | 2019-04-18 |
| 1811454226 | Mohansic Dialysis, LLC | Clinic/Center | 8123 Richmond Hwy, Alexandria, VA 22309-3613 | 2019-02-22 |
| 1720552110 | Shawano Dialysis, LLC | Clinic/Center | 13859 Village Place Dr, Midlothian, VA 23114-3503 | 2019-01-18 |
| 1528533171 | Gansett Dialysis, LLC | Clinic/Center | 8605 Westwood Center Dr Ste 100, Vienna, VA 22182-2231 | 2018-10-10 |
| 1518449784 | Renal Treatment Centers - Mid-atlantic Inc | Clinic/Center | 19980 Highland Vista Dr Ste 100, Ashburn, VA 20147-4189 | 2018-09-04 |
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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.