KIDNEY REPLACEMENT THERAPIES, SC (NPI# 1720283302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720283302 |
| Entity Type | Organization |
| Organization Name | KIDNEY REPLACEMENT THERAPIES, SC |
| Practice Address |
6125 Green Bay Rd Suite 100 Kenosha WI 53142-2928 |
| Practice Telephone | 2625648636 |
| Practice Fax Number | 2625648637 |
| Mailing Telephone | 2625648636 |
| Mailing Fax Number | 2625648637 |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2014-12-19 |
| Authorized Official Name | GANESH N PULLA (DOCTOR) |
| Authorized Official Telephone | 2625648636 |
| Authorized Official Credential | MD |
| 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 |
40695-20 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 21279800 | 05 |
| Street Address |
6125 GREEN BAY RD SUITE 100 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-2928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730155573 | Victor Stephen Slana | Ophthalmology | 6125 Green Bay Rd, Ste 800, Kenosha, WI 53142-2928 | 2006-02-23 |
| 1144493792 | Laurie Ann Robertson | Optometrist | 6125 Green Bay Rd, Suite 800, Kenosha, WI 53142-2928 | 2008-04-03 |
| 1043415631 | Surya Medical Group Sc | Internal Medicine | 6125 Green Bay Rd, Suite 100, Kenosha, WI 53142-2928 | 2007-06-15 |
| 1730219924 | Kenosha Kidney Dialysis LLC | Clinic/Center | 6125 Green Bay Rd, Suite 100, Kenosha, WI 53142-2942 | 2007-03-06 |
| 1295876647 | Frank Serrecchia | Pediatrics | 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928 | 2007-02-09 |
| 1295887321 | V. Stephen Slana, M.d.,s.c. | Durable Medical Equipment & Medical Supplies | 6125 Green Bay Rd, Suite 800, Kenosha, WI 53142-2928 | 2007-01-17 |
| 1962559302 | Bharathi Pulla | Family Medicine | 6125 Green Bay Rd, Kenosha, WI 53142-2928 | 2007-01-05 |
| 1679620918 | Ganesh N Pulla | Internal Medicine | 6125 Green Bay Rd, 100, Kenosha, WI 53142-2928 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| 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 |
|---|---|---|---|---|
| 1174556856 | Midwest Kidney Care, LLC | Clinic/Center | 6804 Green Bay Rd, Suite 108, Kenosha, WI 53142-1452 | 2006-07-08 |
| 1952647737 | Fresenius Medical Care Midwest Dialysis, LLC | Clinic/Center | 6804 Green Bay Rd, Suite 108, Kenosha, WI 53142-1452 | 2012-12-24 |
| 1730219924 | Kenosha Kidney Dialysis LLC | Clinic/Center | 6125 Green Bay Rd, Suite 100, Kenosha, WI 53142-2942 | 2007-03-06 |
| 1003831132 | Froedtert South, Inc. | Clinic/Center | 6308 8th Ave, Kenosha, WI 53143-5031 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171599 | Dubuque Internal Medicine, PC | Clinic/Center | 190 N Orange St, Richland Center, WI 53581-2163 | 2020-10-13 |
| 1316570989 | Fresenius Medical Care Midwest Dialysis, LLC | Clinic/Center | 5125 W Morgan Ave, Greenfield, WI 53220-1540 | 2020-02-21 |
| 1992352082 | Fresenius Kidney Care Madison, LLC | Clinic/Center | 4600 American Pkwy Ste 102, Madison, WI 53718-8334 | 2019-08-22 |
| 1770040859 | Fresenius Medical Care Oshkosh, LLC | Clinic/Center | 2700 W 9th Ave Ste 101a, Oshkosh, WI 54904-7201 | 2019-02-26 |
| 1972008704 | Midwest Legacy Capital LLC | Clinic/Center | W4233 State Rd 54, Black Creek, WI 54106-8633 | 2018-03-26 |
| 1841792603 | Wisconsin Renal Care Group, L.L.C. | Clinic/Center | 17500 W Capitol Drive, Brookfield, WI 53045 | 2018-03-07 |
| 1992212286 | Total Renal Care Inc | Clinic/Center | 733 E Capitol Dr, Milwaukee, WI 53212 | 2018-01-08 |
| 1023527058 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 2831 Okeeffe Ave, Sun Prairie, WI 53590-7057 | 2017-09-21 |
| 1093234569 | Fresenius Medical Care Milwaukee, LLC | Clinic/Center | 2615 W Silver Spring Dr, Milwaukee, WI 53209-4219 | 2017-09-15 |
| 1770010928 | Total Renal Care Inc | Clinic/Center | 9127 N 76th St, Milwaukee, WI 53223-1905 | 2017-05-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KIDNEY REPLACEMENT THERAPIES, SC.
| 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.