LIBERTY DIALYSIS - LAFAYETTE LLC (NPI# 1245320639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245320639 |
| Entity Type | Organization |
| Organization Name | LIBERTY DIALYSIS - LAFAYETTE LLC |
| Other Organization Name | LIBERTY DIALYSIS - LAFAYETTE II |
| Practice Address |
1020 N 18th St Lafayette IN 47904-2279 |
| Mailing Address |
7650 Se 27th St Suite 200 Mercer Island WA 98040-3060 |
| Practice Telephone | 7654208000 |
| Mailing Telephone | 2062365001 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-08-08 |
| Authorized Official Name | MR. RYAN B 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 - Lafayette II | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881784270 | Liberty Dialysis - Lafayette LLC | Clinic/Center | 1300 S Jackson St, Frankfort, IN 46041-3313 | 2006-10-13 |
| 1518057918 | Liberty Dialysis - Lafayette LLC | Clinic/Center | 810 S 6th St, Monticello, IN 47960-8201 | 2006-10-13 |
| 1336239730 | Liberty Dialysis - Lafayette LLC | Clinic/Center | 1710 Lafayette Rd, Crawfordsville, IN 47933-1033 | 2006-10-13 |
| Street Address |
1020 N 18TH ST |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47904-2279 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
| 1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
| 1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
| 1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
| 1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
| 1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
| 1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
| 1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
| Find all providers in zip 47904 | ||||
| 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 |
|---|---|---|---|---|
| 1568079085 | Fresenius Medical Care Broussard, LLC | Clinic/Center | 138 Youngsville Highway, Lafayette, LA 70508-4536 | 2020-09-29 |
| 1831685882 | Total Renal Care Inc | Clinic/Center | 2 Executive Dr Ste B, Lafayette, IN 47905-4878 | 2018-07-02 |
| 1194989293 | Dialysis Clinic Inc | Clinic/Center | 301 Alcide Dominique Dr, Lafayette, LA 70506-1052 | 2008-07-17 |
| 1609968254 | Greater Lafayette Health Services | Clinic/Center | 1000 North 18th Street, Lafayette, IN 47904 | 2006-09-29 |
| 1578665956 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 910 Martin Luther King Jr Dr, Lafayette, LA 70501-1856 | 2006-09-05 |
| 1174635932 | Bio-medical Applications of Alabama, Inc. | Clinic/Center | 802 Hospital St, Lafayette, AL 36862-2818 | 2006-08-31 |
| 1972520997 | Wellbound of Lafayette LLC | Clinic/Center | 2 Executive Dr, Suite B, Lafayette, IN 47905-4878 | 2006-07-16 |
| 1104856269 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 1340 Surrey St Ste 101, Lafayette, LA 70501-7647 | 2006-07-04 |
| 1649674359 | Dialysis Clinic Inc | Clinic/Center | 224 Saint Landry St, Suite 3c, Lafayette, LA 70506-3549 | 2014-10-09 |
| 1710315478 | Total Renal Care Inc | Clinic/Center | 314 Youngsville Hwy, Suite 125, Lafayette, LA 70508-4524 | 2013-10-16 |
| Find all providers in LAFAYETTE | ||||
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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.