RENAL TREATMENT CENTERS ILLINOIS INC (NPI# 1902873656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902873656 |
| Entity Type | Organization |
| Organization Name | RENAL TREATMENT CENTERS ILLINOIS INC |
| Other Organization Name | SHENANDOAH DIALYSIS |
| Practice Address |
300 Pershing Ave Shenandoah IA 51601-2355 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7122465220 |
| Practice Fax Number | 7122465226 |
| Mailing Telephone | 6153416814 |
| Mailing Fax Number | 8002938405 |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2020-07-10 |
| Authorized Official Name | JOHN 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 |
|---|---|---|---|
| IA | 0625277 | 05 | |
| NE | 10025304400 | 05 | |
| MO | 1902873656 | 05 |
| Other Name | Type Code |
|---|---|
| Shenandoah Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780062802 | Renal Treatment Centers Illinois Inc | Clinic/Center | 27150 Providence Pkwy, Ste A, Novi, MI 48374-1272 | 2015-05-08 |
| 1508243882 | Renal Treatment Centers Illinois Inc | Clinic/Center | 6770 Dixie Hwy Ste 205, Clarkston, MI 48346-2089 | 2015-05-06 |
| 1568849826 | Renal Treatment Centers Illinois Inc | Clinic/Center | 21900 Melrose Ave Ste 4, Southfield, MI 48075-7967 | 2015-05-06 |
| 1659640522 | Renal Treatment Centers Illinois Inc | Clinic/Center | 610 S 13th St, Norfolk, NE 68701-4969 | 2011-12-22 |
| 1013294156 | Renal Treatment Centers Illinois Inc | Clinic/Center | 7454 N 30th St, Omaha, NE 68112-2722 | 2011-11-03 |
| 1760766984 | Renal Treatment Centers Illinois Inc | Clinic/Center | 6610 S 168th St, Ste 8, Omaha, NE 68135-5412 | 2011-10-06 |
| 1558590620 | Renal Treatment Centers Illinois Inc | Clinic/Center | 3749 Commercial Dr, Indianapolis, IN 46222-1676 | 2009-07-09 |
| 1558505636 | Renal Treatment Centers Illinois Inc | Clinic/Center | 220 10th St Sw, Waverly, IA 50677-2930 | 2009-04-21 |
| 1922269471 | Renal Treatment Centers Illinois Inc | Clinic/Center | 3877 E Galbraith Rd, Bldg C, Cincinnati, OH 45236-1514 | 2008-06-18 |
| 1154505188 | Renal Treatment Centers Illinois Inc | Clinic/Center | 4801 Acorn Dr, Independence, OH 44131-2566 | 2007-12-27 |
| Street Address |
300 PERSHING AVE |
| City | SHENANDOAH |
| State | IA |
| Zip Code | 51601-2355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184621096 | Shenandoah Medical Center | General Acute Care Hospital | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2005-07-07 |
| 1952914566 | Dena Herzberg | Nurse Practitioner | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2020-08-25 |
| 1104317379 | Denise J Mcenaney | Dietitian, Registered | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2018-05-23 |
| 1730697681 | Jessica Anne Heitkamp | Nurse Practitioner | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2018-01-12 |
| 1073964854 | Ashlee Jo Richardson | Physical Therapist | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2016-06-23 |
| 1447609300 | Logan J Kopf | Nurse Anesthetist, Certified Registered | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2016-06-10 |
| 1154797876 | Shala Davidson | Nutritionist | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2015-08-17 |
| 1174908362 | Shenandoah Medical Center | Internal Medicine | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2015-07-29 |
| 1184021602 | Shenandoah Medical Center | Hospitalist | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2014-11-26 |
| 1194079954 | Shenandoah Medical Center | Durable Medical Equipment & Medical Supplies | 300 Pershing Ave, Shenandoah, IA 51601-2355 | 2012-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336589969 | Jenifer Ann Deziel | Nurse Practitioner | Shenandoah Medical Center, 300 Pershing Avenue, Shenandoah, IA 51601 | 2013-06-27 |
| 1154621282 | Md West One, PC | Neurological Surgery | 1 Jack Foster Drive, Shenandoah, IA 51601 | 2010-10-22 |
| 1912119124 | Swfac Plc | Podiatrist | 813 Church St., Shenandoah, IA 51601 | 2007-05-03 |
| 1134246895 | David Carroll Dickson | Pedorthist | 612 W. Sheridan Avenue, Shenandoah, IA 51601 | 2007-03-26 |
| 1558433037 | Joseph Patrick Emge | Dentist | 301 Maple St, Suite 3, Shenandoah, IA 51601 | 2006-11-14 |
| 1487766309 | Scott Richard King | Obstetrics & Gynecology | 300 Pershing Avenue, Shenandoah, IA 51601 | 2006-08-31 |
| 1801904933 | Marvin E Belknap | Dentist | 617 West Thomas, Shenandoah, IA 51601 | 2006-08-28 |
| 1083687636 | Charles J Peterson Dc PC | Chiropractor | 1203 W Sheridan Ave, Shenandoah, IA 51601 | 2006-02-13 |
| 1467692152 | Carol A Stehlik | Nutritionist | 300 Pershing Avenue, Shenandoah, IA 51601-0382 | 2009-02-20 |
| 1265526248 | Nishna Productions, Inc. | Community/Behavioral Health | 902 Day St, Shenandoah, IA 51601-1106 | 2006-10-03 |
| Find all providers in zip 51601 | ||||
| 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 |
|---|---|---|---|---|
| 1023410453 | Bio-medical Applications of Texas, Inc. | Clinic/Center | 1644 Research Forest Dr Ste 150, Shenandoah, TX 77381-4396 | 2014-09-17 |
| 1518319706 | Lone Star Home Dialysis, Inc. | Clinic/Center | 150 Pine Forest Dr, Suite 102, Shenandoah, TX 77384-5302 | 2016-07-12 |
| 1194916205 | The Woodlands Dialysis Center Lp | Clinic/Center | 9301 Pinecroft Dr, Ste130, Shenandoah, TX 77380-3178 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942817218 | Fresenius Medical Care Ottumwa, LLC | Clinic/Center | 1655 E San Marnan Dr Ste E, Waterloo, IA 50702-4380 | 2020-09-30 |
| 1669001038 | Honeyman Dialysis LLC | Clinic/Center | 701 Tama St Ste 150, Marion, IA 52302-4806 | 2020-04-07 |
| 1588221824 | Rcg Mercy Des Moines LLC | Clinic/Center | 9080 University Ave, West Des Moines, IA 50266-1892 | 2019-05-22 |
| 1639634207 | Fresenius Medical Care Ottumwa, LLC | Clinic/Center | 1110 N Quincy Ave Ste 44, Ottumwa, IA 52501-3884 | 2019-02-07 |
| 1245755529 | Trusten Dialysis LLC | Clinic/Center | 1119 73rd St, Windsor Heights, IA 50324-1313 | 2017-08-08 |
| 1477086692 | Wallips Dialysis, LLC | Clinic/Center | 1117 Hazel St, Pella, IA 50219-1338 | 2017-04-05 |
| 1821499245 | Clyfee Dialysis LLC | Clinic/Center | 1228 E Rusholme St Ste 1000, Davenport, IA 52803-2467 | 2014-09-05 |
| 1477980365 | Honeyman Dialysis LLC | Clinic/Center | 1002 4th Ave Se Ste A, Ste A, Cedar Rapids, IA 52403-2425 | 2013-10-09 |
| 1982947792 | Davis Dialysis LLC | Clinic/Center | 5865 Sunnybrook Dr, Sioux City, IA 51106-4203 | 2013-03-29 |
| 1972843738 | Geyser Dialysis LLC | Clinic/Center | 2625 N Ankeny Blvd, Ankeny, IA 50023 | 2013-02-15 |
| Find all providers with the same taxonomy | ||||
| City | SHENANDOAH |
| Zip Code | 51601 |
Please comment or provide details below to improve the information on RENAL TREATMENT CENTERS ILLINOIS INC.
| 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.