BRIDGES DIALYSIS LLC (NPI# 1003119876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003119876 |
| Entity Type | Organization |
| Organization Name | BRIDGES DIALYSIS LLC |
| Other Organization Name | FORT WAYNE SOUTH DIALYSIS |
| Practice Address |
302 E Pettit Ave Fort Wayne IN 46806-3007 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 2604560451 |
| Practice Fax Number | 2604589269 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2020-08-24 |
| Authorized Official Name | JOHN D 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 |
|---|---|---|---|
| IN | 201048390A | 05 |
| Other Name | Type Code |
|---|---|
| Fort Wayne South Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558635276 | Bridges Dialysis LLC | Clinic/Center | 3233 E Coliseum Blvd, Fort Wayne, IN 46805-1561 | 2012-02-27 |
| 1093012544 | Bridges Dialysis LLC | Clinic/Center | 1833 Magnavox Way, Fort Wayne, IN 46804-1539 | 2011-02-18 |
| 1366745630 | Bridges Dialysis LLC | Clinic/Center | 4916 Illinois Rd, Suite 118, Fort Wayne, IN 46804-5116 | 2010-12-08 |
| Street Address |
302 E PETTIT AVE |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46806-3007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841574829 | Daniel E Purvis Jr. | Pharmacist | 222 E Pettit Avenue, Fort Wayne, IN 46806 | 2011-10-07 |
| 1558645754 | Logan M Franke | Pharmacist | 222 E Pettit Ave, Fort Wayne, IN 46806 | 2011-10-06 |
| 1356513725 | Seazoned Med Transportation Service | Non-emergency Medical Transport (VAN) | 2809 Smith Street, Fort Wayne, IN 46806 | 2008-03-26 |
| 1376711267 | Hector F Perez Md PC | Family Medicine | 5717 So Anthony, Ste 500, Fort Wayne, IN 46806 | 2008-02-14 |
| 1326249376 | Purdue University | Dentist | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-05-29 |
| 1174657480 | Robert Anthony Ford | Case Manager/Care Coordinator | 525 Oxford St., Fort Wayne, IN 46806 | 2007-03-16 |
| 1508069972 | Indiana University | Clinic/Center | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-06-06 |
| 1669622403 | Sally J Hartman | Nurse Practitioner | 2700 S Lafayette St, Suite 200, Fort Wayne, IN 46806-1100 | 2008-09-30 |
| 1003099441 | Lafayette Foot and Ankle Clinic | Podiatrist | 2700 Lafayette St Ste 230, Fort Wayne, IN 46806-1100 | 2007-12-07 |
| 1033259197 | V E Butler and Associates PC | Pharmacist | 2700 S. Lafayette St, Communitycare Pharmacy, Fort Wayne, IN 46806-1100 | 2007-02-07 |
| Find all providers in zip 46806 | ||||
| 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 |
|---|---|---|---|---|
| 1558716019 | Duston Dialysis, LLC | Clinic/Center | 415 E Dupont Rd, Fort Wayne, IN 46825-2051 | 2016-05-03 |
| 1659796233 | Randolph Dialysis LLC | Clinic/Center | 6721 Old Trail Rd, Ste 100, Fort Wayne, IN 46809-2655 | 2014-02-19 |
| 1558635276 | Bridges Dialysis LLC | Clinic/Center | 3233 E Coliseum Blvd, Fort Wayne, IN 46805-1561 | 2012-02-27 |
| 1093012544 | Bridges Dialysis LLC | Clinic/Center | 1833 Magnavox Way, Fort Wayne, IN 46804-1539 | 2011-02-18 |
| 1366745630 | Bridges Dialysis LLC | Clinic/Center | 4916 Illinois Rd, Suite 118, Fort Wayne, IN 46804-5116 | 2010-12-08 |
| 1770698524 | Maumee Dialysis Services, LLC | Clinic/Center | 10204 Dupont Circle Dr E, Fort Wayne, IN 46825-1611 | 2006-08-20 |
| 1174579551 | Isd Renal Inc | Clinic/Center | 3909 Lake Ave, Fort Wayne, IN 46805-5545 | 2006-05-26 |
| 1992751556 | Isd Renal Inc | Clinic/Center | 1940 Bluffton Rd, Fort Wayne, IN 46809-1307 | 2006-05-25 |
| 1639124886 | Dsi Renal Inc | Clinic/Center | 2414 Lake Ave, Fort Wayne, IN 46805-5406 | 2006-05-24 |
| 1386699445 | Isd Renal Inc | Clinic/Center | 7017 S Anthony Blvd, Fort Wayne, IN 46816-2016 | 2006-05-24 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46806 |
Please comment or provide details below to improve the information on BRIDGES DIALYSIS LLC.
| 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.