MAPLE GROVE DIALYSIS LLC (NPI# 1255518247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255518247 |
| Entity Type | Organization |
| Organization Name | MAPLE GROVE DIALYSIS LLC |
| Other Organization Name | MAPLE GROVE DIALYSIS UNIT |
| Practice Address |
15655 Grove Cir N Maple Grove MN 55369-4489 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7634202804 |
| Practice Fax Number | 7634207162 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2019-01-07 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| 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 |
|---|---|---|---|
| MN | 1255518247 | 05 |
| Other Name | Type Code |
|---|---|
| Maple Grove Dialysis Unit | Doing Business As Name - Organization |
| Street Address |
15655 GROVE CIR N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-4489 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| 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 |
|---|---|---|---|---|
| 1679731731 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 7365 Kirkwood Ct N, Suite 135, Maple Grove, MN 55369-4721 | 2008-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183832 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 6160 Summit Dr N Ste 150, Brooklyn Center, MN 55430-2118 | 2020-10-28 |
| 1902392111 | Chaffee Dialysis LLC | Clinic/Center | 862 Arcade St, Saint Paul, MN 55106 | 2018-07-11 |
| 1225541055 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 7433 Currell Blvd, Woodbury, MN 55125-2217 | 2017-11-15 |
| 1154856839 | Avera Marshall | Clinic/Center | 300 S Bruce St Ste D, Marshall, MN 56258-1934 | 2017-05-01 |
| 1225573777 | Atlantic Dialysis LLC | Clinic/Center | 1802 Commerce Dr, North Mankato, MN 56003-1800 | 2016-12-19 |
| 1437694981 | Atlantic Dialysis LLC | Clinic/Center | 701 N Broadway St, New Ulm, MN 56073-1201 | 2016-12-19 |
| 1467801860 | Total Renal Care, Inc. | Clinic/Center | 20184 Heritage Dr, Lakeville, MN 55044-6855 | 2016-06-07 |
| 1003292392 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 17592 Dodd Blvd, Lakeville, MN 55044-3909 | 2015-08-10 |
| 1629461470 | Babler Dialysis, LLC | Clinic/Center | 2660 S Broadway, Ste A, Rochester, MN 55904-6263 | 2015-03-17 |
| 1588067391 | Meesa Dialysis LLC | Clinic/Center | 245 Isle St W, Isle, MN 56342-4908 | 2014-10-07 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
Please comment or provide details below to improve the information on MAPLE GROVE 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.