RENAL LIFE LINK, INC. (NPI# 1730273228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730273228 |
| Entity Type | Organization |
| Organization Name | RENAL LIFE LINK, INC. |
| Other Organization Name | CENTRAL BROADWAY DIALYSIS |
| Practice Address |
716 W Broadway Louisville KY 40202 |
| Mailing Address |
5200 Virginia Way Ste 400 L&c Brentwood TN 37027 |
| Practice Telephone | 6153204218 |
| Mailing Telephone | 6153204218 |
| Mailing Fax Number | 3032097825 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOMAS O USILTON JR. (SR VICE PRESIDENT) |
| Authorized Official Telephone | 7705417922 |
| 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 |
| Other Name | Type Code |
|---|---|
| Central Broadway Dialysis | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | RENAL LIFE LINK, INC. | Jld/secgovfin 2000 16th Street, Denver, CO 80202 |
| Street Address |
716 W BROADWAY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770543217 | Adrian Cosmin | Internal Medicine | 716 W Broadway, Louisville, KY 40202-2216 | 2006-03-27 |
| 1154934743 | Casey Nicole Prestigiacomo | Nurse Practitioner | 716 W Broadway, Louisville, KY 40202-2216 | 2020-08-25 |
| 1366095242 | Reneka Shavon Wigginton | Nurse Practitioner | 716 W Broadway, Louisville, KY 40202-2216 | 2019-07-19 |
| 1740640366 | Juliann Benson | Nurse Practitioner | 716 W Broadway, Louisville, KY 40202-2216 | 2016-02-24 |
| 1538534342 | Jennifer L Hardin | Nurse Practitioner | 716 W Broadway, Louisville, KY 40202 | 2015-12-04 |
| 1295179091 | Ronald O Hale | Nurse Practitioner | 716 W Broadway, Louisville, KY 40202-2216 | 2013-04-23 |
| 1295083517 | Amy Alexander | Registered Nurse | 716 W Broadway, Louisville, KY 40202-2216 | 2012-08-16 |
| 1235459553 | American Access Center LLC | Clinic/Center | 716 W Broadway, Louisville, KY 40202-2216 | 2010-06-09 |
| 1205150992 | Luisa Maria Franco | Internal Medicine | 716 W Broadway, Louisville, KY 40202-2216 | 2010-03-24 |
| 1215264171 | Tavonie Michelle Ford-gibbons | Nurse Practitioner | 716 W Broadway, Louisville, KY 40202-2216 | 2009-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| Find all providers in zip 40202 | ||||
| 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 |
|---|---|---|---|---|
| 1962000232 | Fresenius Medical Care Kentuckiana Ht, LLC | Clinic/Center | 6400 Dutchmans Pkwy Ste 145, Louisville, KY 40205-3342 | 2020-10-09 |
| 1659988970 | Dialyze Direct Ky, LLC | Clinic/Center | 9780 Ormsby Station Rd Ste 1200, Louisville, KY 40223-4049 | 2020-09-30 |
| 1629602727 | Pure Life Renal of Louisville, LLC | Clinic/Center | 3935 Taylorsville Rd, Louisville, KY 40220-1455 | 2020-02-27 |
| 1093213902 | Bio-medical Applications of Kentucky, Inc. | Clinic/Center | 1715 Gagel Ave, Louisville, KY 40216-2763 | 2018-01-25 |
| 1386038040 | Lufield Dialysis LLC | Clinic/Center | 2118 Portland Ave, Louisville, KY 40212-1032 | 2015-03-20 |
| 1871927293 | University Kidney Center Broadway LLC | Clinic/Center | 2821 West Broadway, Louisville, KY 40211-1218 | 2013-08-22 |
| 1649603705 | University Kidney Center Hikes Lane LLC | Clinic/Center | 2271 Hikes Ln, Louisville, KY 40218-2203 | 2013-08-13 |
| 1497048342 | Sugarite Dialysis LLC | Clinic/Center | 4600 Shelbyville Rd Ste 310, Louisville, KY 40207-2391 | 2011-05-25 |
| 1871720763 | James More | Clinic/Center | 2149 Goldsmith Ln, Louisville, KY 40218-1219 | 2009-06-17 |
| 1386878502 | Louisville Dialysis Clinic LLC | Clinic/Center | 817 Peachtree St, Louisville, GA 30434-1449 | 2009-05-04 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40202 |
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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.