LIBERTY DIALYSIS - LAKELAND LLC (NPI# 1013231620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013231620 |
| Entity Type | Organization |
| Organization Name | LIBERTY DIALYSIS - LAKELAND LLC |
| Other Organization Name | LIBERTY DIALYSIS AT LAKELAND ROYALTON |
| Practice Address |
3772 Hollywood Rd Saint Joseph MI 49085-9550 |
| Mailing Address |
7650 Se 27th St Suite 200 Mercer Island WA 98040-3060 |
| Practice Telephone | 2694287474 |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2017-07-19 |
| Authorized Official Name | RYAN PARDO (VICE PRESIDENT) |
| Authorized Official Telephone | 2062365001 |
| 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 |
|---|---|
| Liberty Dialysis at Lakeland Royalton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760706378 | Liberty Dialysis - Lakeland LLC | Clinic/Center | 8 Longmeadow Village Dr, Niles, MI 49120-7808 | 2010-03-25 |
| Street Address |
3772 HOLLYWOOD RD |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-9550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932209350 | Lakeland Hospitals At Niles and St Joseph, Inc | Clinic/Center | 3772 Hollywood Rd, Saint Joseph, MI 49085-9550 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758949 | Ahmed Elshareif | Student in an Organized Health Care Education/Training Program | Lakeland Health, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2020-04-03 |
| 1033747225 | Ezra Fox | Student in an Organized Health Care Education/Training Program | Lakeland Health- Gme, 1234 Napier Avenue, St. Joseph, MI 49085 | 2020-04-01 |
| 1679033930 | Asad Butt | Student in an Organized Health Care Education/Training Program | Lakeland Health-gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2019-03-22 |
| 1184194714 | Benjamin Phillip Knuth | Physical Therapist | 3950 Hollywood Road, Suite 140, Saint Joseph, MI 49085 | 2018-11-27 |
| 1336624279 | Brandi Chatot | Counselor | 1101 Broad Street #8, Saint Joseph, MI 49085 | 2018-09-26 |
| 1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
| 1760976518 | Premier Health Associates, Inc. | Home Health | 1111 Main Sr, St Joseph, MI 49085 | 2018-06-15 |
| 1053817783 | Chantell Strong | Student in an Organized Health Care Education/Training Program | Lakeland Health - Gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2018-04-02 |
| 1386144053 | Anjana Gupta, Dds, Pllc | Dentist | 2800 Niles Road, Saint Joseph, MI 49085 | 2018-02-19 |
| 1356858997 | Hope Reborn Counseling, Pllc | Counselor | 2816 Willa Dr, Saint Joseph, MI 49085 | 2018-01-04 |
| Find all providers in zip 49085 | ||||
| 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 |
|---|---|---|---|---|
| 1932209350 | Lakeland Hospitals At Niles and St Joseph, Inc | Clinic/Center | 3772 Hollywood Rd, Saint Joseph, MI 49085-9550 | 2006-09-25 |
| 1578524104 | Dva Renal Healthcare Inc | Clinic/Center | 5514 Corporate Dr Ste 100, Saint Joseph, MO 64507-7754 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497961 | Saint Marina Home Dialysis LLC | Clinic/Center | 26711 Northwestern Hwy Ste 125, Southfield, MI 48033-2170 | 2020-11-05 |
| 1144820226 | Heritage Home Dialysis LLC | Clinic/Center | 1580 N Leroy St Ste 6, Fenton, MI 48430-2801 | 2020-10-28 |
| 1386262350 | Delta Renal Care Pllc | Clinic/Center | 3981 Elizabeth Ave, Canton, MI 48188-7223 | 2020-07-07 |
| 1457973257 | Fms Owosso, LLC | Clinic/Center | 918 Corunna Ave, Owosso, MI 48867-3768 | 2020-05-14 |
| 1023650926 | Falmont Dialysis LLC | Clinic/Center | 37290 5 Mile Rd, Livonia, MI 48154-1848 | 2019-10-11 |
| 1487112942 | Michigan Dialysis Services, LLC | Clinic/Center | 275 N Canton Center Rd, Canton, MI 48187 | 2019-03-04 |
| 1487123600 | Concerto Michigan LLC | Clinic/Center | 14700 Farmington Rd Ste 108, Livonia, MI 48154-5462 | 2018-11-16 |
| 1245715291 | Brooksprings Dialysis, LLC | Clinic/Center | 2391 Fifteen Mile Rd, Sterling Heights, MI 48310 | 2018-09-26 |
| 1851886592 | Fms Rochester Hills, LLC | Clinic/Center | 26400 W 12 Mile Rd Ste 112, Southfield, MI 48034-1785 | 2018-06-26 |
| 1801399753 | Kasaskia Dialysis LLC | Clinic/Center | 18001 E 10 Mile Rd Ste B, Roseville, MI 48066-3803 | 2018-03-16 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 49085 |
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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.