RENAL TREATMENT CENTERS - SOUTHEAST, LP


Address: 1110 Hospital Rd, Suite A, Fort Walton Beach, FL 32547-6644
Phone: 8508626989

RENAL TREATMENT CENTERS - SOUTHEAST, LP (NPI# 1255397170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255397170
Entity Type Organization
Organization Name RENAL TREATMENT CENTERS - SOUTHEAST, LP
Other Organization Name FORT WALTON BEACH DIALYSIS
Practice Address 1110 Hospital Rd
Suite A
Fort Walton Beach
FL 32547-6644
Mailing Address 5200 Virginia Way
Ste. 400 L&c
Brentwood
TN 37027-7569
Practice Telephone 8508626989
Practice Fax Number 8508620014
Mailing Telephone 6153204218
Mailing Fax Number 3032097825
Enumeration Date 2006-04-21
Last Update Date 2007-07-12
Authorized Official Name THOMAS O. USILTON JR. (GROUP VICE PRESIDENT)
Authorized Official Telephone 7705417922
Is Organization Subpart N

Taxonomy

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 Provider/Organization Names

Other Name Type Code
Fort Walton Beach Dialysis Doing Business As Name - Organization

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1396140083 Renal Treatment Centers - Southeast, Lp Clinic/Center 101 N 37th St, Rogers, AR 72756-0301 2014-10-24

Office Location

Street Address 1110 HOSPITAL RD
SUITE A
City FORT WALTON BEACH
State FL
Zip Code 32547-6644

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023664182 Edward Paul Meadors Jr. Physical Therapist 1110 Hospital Rd, Fort Walton Beach, FL 32547-6742 2019-08-14
1144571852 Matthew Aaron Leary Physical Therapist 1110 Hospital Rd, Building B, Fort Walton Beach, FL 32547-6778 2012-09-21
1043238942 Ob/gyn Specialists of The Emerald Coast Obstetrics & Gynecology 1110 Hospital Rd, Suite C, Fort Walton Beach, FL 32547-6778 2006-07-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255944955 Theresa Ann Morvay Behavior Technician 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 2020-08-24
1588295422 Emily Ann Glossop Nurse Practitioner 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 2020-01-29
1225669443 Elizabeth Rogers Nagengast Physician Assistant 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 2020-01-27
1497254791 Carmen Alston Nurse Practitioner 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 2018-02-02
1871004960 Center for Neuropsychological Services Cns Clinical Neuropsychologist 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 2017-10-17
1194235648 Robin Wray Speech-Language Pathologist 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 2017-10-10
1285007989 Dynamic Pain & Wellness Pllc Pain Medicine 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 2015-11-04
1013392810 Terry Abbott Social Worker 648 Overbrook Dr, Fort Walton Beach, FL 32547 2015-07-22
1083024673 Emily Lohr Physical Therapy Assistant 2000 Principle Ln, Ft. Walton Beach, FL 32547 2014-05-05
1831526102 Laurie Ann Schweppe Nurse Practitioner 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 2013-10-02
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Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750800991 Bio-medical Applications of Florida, Inc. Clinic/Center 315 Green Acres Rd, Fort Walton Beach, FL 32547-6132 2017-09-19
1528584745 Hampton Dialysis LLC Clinic/Center 1112 Hospital Rd, Fort Walton Beach, FL 32547-6742 2017-08-18
1447362280 Renal Care Group of The Southeast, Inc. Clinic/Center 925 Mar Walt Dr, Suite 2, Fort Walton Beach, FL 32547-6609 2006-08-31

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1801496104 Kidney Care Center of Winter Haven LLC Clinic/Center 1107 3rd St Sw Ste 9, Winter Haven, FL 33880-3912 2020-10-27
1538773411 5072020, LLC Clinic/Center 2675 Winkler Ave Ste 130, Fort Myers, FL 33901-9362 2020-09-08
1750992814 Swain Dialysis Renal Center Clinic/Center 1923 Nw 43rd St, Miami, FL 33142-4777 2020-08-12
1396355525 Kidney Partners Coral Gables LLC Clinic/Center 835 Sw 37th Ave, Miami, FL 33135-4289 2020-08-03
1427668870 Dialysis Spa, LLC Clinic/Center 2040 Ne 163rd St Ste 206, North Miami Beach, FL 33162-4953 2020-07-31
1285250522 Fresenius Medical Care Casselberry, LLC Clinic/Center 775 Gateway Dr Ste 1010, Altamonte Springs, FL 32714-1524 2020-06-23
1992321244 Fresenius Medical Care Casselberry, LLC Clinic/Center 750 Northlake Blvd Ste 1024, Altamonte Springs, FL 32701-6745 2020-06-23
1023630886 Fresenius Medical Care Apollo Beach, LLC Clinic/Center 3002 E College Ave, Ruskin, FL 33570-5220 2020-05-14
1124640263 Arc Dialysis Westchester LLC Clinic/Center 11501 Sw 40th St Ste 100, Miami, FL 33165-3313 2020-05-12
1487274734 Bio-medical Applications of Florida, Inc. Clinic/Center 2777 University Blvd W Ste 39, Jacksonville, FL 32217-2143 2020-04-16
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Competitor

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City FORT WALTON BEACH
Zip Code 32547

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Dataset Information

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.

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