WISCONSIN DIALYSIS, INC. (NPI# 1114035912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114035912 |
| Entity Type | Organization |
| Organization Name | WISCONSIN DIALYSIS, INC. |
| Other Organization Name | EAST CLINIC |
| Practice Address |
4600 American Pkwy Ste 108 Madison WI 53718-8337 |
| Mailing Address |
3034 Fish Hatchery Rd Fitchburg WI 53713-3125 |
| Practice Telephone | 6082433003 |
| Practice Fax Number | 6082433005 |
| Mailing Telephone | 6082705600 |
| Mailing Fax Number | 6082705602 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-06-24 |
| Authorized Official Name | KRISTINE HOLMES (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6082705624 |
| 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 |
|---|---|---|---|
| WI | 42059900 | 05 |
| Other Name | Type Code |
|---|---|
| East Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881702603 | Wisconsin Dialysis, Inc. | Clinic/Center | 3034 Fish Hatchery Rd, Fitchburg, WI 53713-3125 | 2006-08-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WISCONSIN DIALYSIS, INC. | 3034 Fish Hatchery Rd, Fitchburg, WI 53713-3125 |
| Street Address |
4600 AMERICAN PKWY STE 108 |
| City | MADISON |
| State | WI |
| Zip Code | 53718-8337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023102563 | Bette M Trimble | Counselor | 4600 American Pkwy, Suite 206, Madison, WI 53718-8333 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475607 | Suchart Thammahong | Pharmacist | 734 Mclean Drive, Madison, Wi, WI 53718 | 2020-10-21 |
| 1780033431 | Elizabeth C Armstrong | Registered Nurse | 2810 Crossroads Dr Ste 4000, Madison, WI 53718 | 2016-06-03 |
| 1811356926 | Quirt Family Dentistry, Sc | Dentist | 6038 Gemini Drive, Madison, WI 53718 | 2016-02-17 |
| 1831583145 | Madison Rehabilitation Hospital, LLC | Rehabilitation Hospital | 5115 N Biltmore Ln, Madison, WI 53718 | 2015-03-25 |
| 1972919959 | Hannah E Kussler | Physician Assistant | The American Center, 4602 Eastpark Blvd, Madison, WI 53718 | 2014-07-10 |
| 1104187079 | Kaitlin Hellenbrand | Occupational Therapist | 5249 East Terrace Drive, Madison, WI 53718 | 2012-06-06 |
| 1003172800 | Wisconsin Hyperbaric Oxygen LLC | Clinic/Center | 4660 S Biltmore Lane, Madison, WI 53718 | 2012-04-05 |
| 1801022850 | Justin Robert Bangert | Marriage & Family Therapist | 5310 Wall St., Ste #500, Madison, WI 53718 | 2009-06-04 |
| 1427292275 | Jane Louise Stroede | Physical Therapy Assistant | 2802 Walton Commons West, Madison, WI 53718 | 2009-04-23 |
| 1003060658 | Candace Leigh Pantoga | Occupational Therapist | 3030 City View Drive, City View Nursing Home, Madison, WI 53718 | 2008-11-10 |
| Find all providers in zip 53718 | ||||
| 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 |
|---|---|---|---|---|
| 1992352082 | Fresenius Kidney Care Madison, LLC | Clinic/Center | 4600 American Pkwy Ste 102, Madison, WI 53718-8334 | 2019-08-22 |
| 1053836486 | American Kidney Center of Madison LLC | Clinic/Center | 419 Clifty Dr, Madison, IN 47250-1607 | 2017-08-07 |
| 1487108668 | Total Renal Care, Inc | Clinic/Center | 1221 Briarville Rd, Madison, TN 37115-5145 | 2016-08-05 |
| 1013301779 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 2840 Index Rd., Madison, WI 53713 | 2015-03-20 |
| 1114368065 | Bio-medical Applications of Alabama, Inc. | Clinic/Center | 29569 Huntsville Brownsferry Rd, Madison, AL 35756-3639 | 2013-07-08 |
| 1871680264 | Athens Kidney Center, PC | Clinic/Center | 1311 Atlanta Hwy, Madison, GA 30650-2069 | 2006-10-06 |
| 1245342054 | Bio-medical Applications of Alabama, Inc. | Clinic/Center | 40 Hughes Rd, Madison, AL 35758-2220 | 2006-08-31 |
| 1396762035 | Bio-medical Applications of Indiana, Inc. | Clinic/Center | 1708 Cragmont St, Madison, IN 47250-2808 | 2006-07-17 |
| 1861420416 | Dialysis Clinic Inc. | Clinic/Center | 605 W Due West Ave, Madison, TN 37115-4423 | 2006-06-30 |
| 1073577532 | Renal Treatment Centers Illinois Inc | Clinic/Center | 220 Clifty Dr, Unit K, Madison, IN 47250-1696 | 2006-04-13 |
| Find all providers in MADISON | ||||
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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.