WAKONDA DIALYSIS LLC (NPI# 1992223556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992223556 |
| Entity Type | Organization |
| Organization Name | WAKONDA DIALYSIS LLC |
| Other Organization Name | MT NEBO DIALYSIS |
| Practice Address |
555 W State Road 164 Ste 101 Salem UT 84653-5732 |
| Mailing Address |
5200 Virginia Way Brentwood TN 37027-7569 |
| Practice Telephone | 8017987903 |
| Practice Fax Number | 8017987237 |
| Mailing Telephone | 6153416814 |
| Mailing Fax Number | 8002938405 |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2019-10-16 |
| Authorized Official Name | JAMES HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| 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 |
|---|---|
| Mt Nebo Dialysis | Doing Business As Name - Organization |
| Street Address |
555 W STATE ROAD 164 STE 101 |
| City | SALEM |
| State | UT |
| Zip Code | 84653-5732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487008603 | Douglas Robert Clark | Optometrist | 446 N State Road 198, Salem, UT 84653 | 2016-04-14 |
| 1811357791 | Melanie Pace | Dental Hygienist | 818 East 750 South, Salem, UT 84653 | 2016-03-04 |
| 1265773899 | Bill Clifford Marshall | Marriage & Family Therapist | 405 S Maple Dr, Woodland Hills, UT 84653 | 2013-03-06 |
| 1013159995 | Elder Assisted Living LLC | Assisted Living Facility | 1015 S 550 W, Salem, UT 84653 | 2009-03-24 |
| 1780884247 | David Kent Hansen | Dentist | 204 East 400 North, Suite A, Salem, UT 84653 | 2007-07-23 |
| 1154524965 | Justin Thomas Perry | Dentist | 40 South 200 West, Salem, UT 84653 | 2007-06-08 |
| 1013130947 | John E Braithwaite | Dentist | 40 S 200 W, Salem, UT 84653 | 2007-04-10 |
| 1104972827 | Salem City Corporation | Ambulance | 30 W 100 S, Salem, UT 84653 | 2007-01-26 |
| 1700989209 | James Bryan Bonny | Dentist | 245 W State Hwy 198, Suite 6, Salem, UT 84653 | 2006-09-07 |
| 1578574570 | Kids Who Count | Day Training, Developmentally Disabled Services | 345 N Sr 198, Salem, UT 84653 | 2006-08-11 |
| Find all providers in zip 84653 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| 1659839181 | Total Renal Care Inc | Clinic/Center | 645 9th St Nw, Salem, OR 97304-3132 | 2019-03-04 |
| 1215485883 | Belmont Dialysis LLC | Clinic/Center | 3737 W Main St Ste 103, Salem, VA 24153-2073 | 2016-09-13 |
| 1821463555 | Total Renal Care Inc | Clinic/Center | 421 Lancaster Dr Ne, Salem, OR 97301-4729 | 2015-12-07 |
| 1891120812 | Bio-medical Applications of New Hampshire, Inc. | Clinic/Center | 19 Keewaydin Dr Ste A, Salem, NH 03079-4891 | 2013-09-10 |
| 1194066878 | Total Renal Care Inc | Clinic/Center | 4792 Portland Rd Ne, Salem, OR 97305-3920 | 2013-03-06 |
| 1942531843 | Renal Care Group Eastern Ohio, LLC | Clinic/Center | 2345 E Pershing St, Salem, OH 44460-3400 | 2010-01-18 |
| 1376784579 | New Springs Dialysis LLC | Clinic/Center | 1201 N Jim Day Rd, Ste 103, Salem, IN 47167-7219 | 2009-03-18 |
| 1376799957 | Fresenius Medical Care Dialysis Services-oregon, LLC | Clinic/Center | 1060 2nd St Nw, Salem, OR 97304 | 2008-08-14 |
| 1689709594 | Renal Treatment Centers Illinois Inc | Clinic/Center | 1201 N Jim Day Road, Ste 103, Salem, IN 47167 | 2007-02-22 |
| Find all providers in SALEM | ||||
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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.