RENAL CARE GROUP OF THE SOUTHEAST, INC. (NPI# 1447362280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1447362280 |
Entity Type | Organization |
Organization Name | RENAL CARE GROUP OF THE SOUTHEAST, INC. |
Other Organization Name | RENAL CARE GROUP FT. WALTON BEACH |
Practice Address |
925 Mar Walt Dr Suite 2 Fort Walton Beach FL 32547-6609 |
Practice Telephone | 8508644411 |
Practice Fax Number | 8508644464 |
Mailing Telephone | 8508644411 |
Mailing Fax Number | 8508644464 |
Enumeration Date | 2006-08-31 |
Last Update Date | 2010-05-10 |
Authorized Official Name | MARK FAWCETT (TREASURER) |
Authorized Official Telephone | 7816999000 |
Is Organization Subpart | Y |
Parent Organization Name | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
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 |
---|---|
RENAL CARE GROUP FT. WALTON BEACH | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053587691 | Renal Care Group of The Southeast, Inc. | Clinic/Center | 43 Shoemaker Dr, Defuniak Springs, FL 32433-4046 | 2008-05-04 |
1992817738 | Renal Care Group of The Southeast, Inc. | Clinic/Center | 1305 W Moreno St, Pensacola, FL 32501-2321 | 2006-08-31 |
1629180468 | Renal Care Group of The Southeast, Inc. | Clinic/Center | 6001 Industrial Blvd, Century, FL 32535-3312 | 2006-08-31 |
Street Address |
925 MAR WALT DR SUITE 2 |
City | FORT WALTON BEACH |
State | FL |
Zip Code | 32547-6609 |
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 |
Find all providers in zip 32547 |
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 |
---|---|---|---|---|
1750800991 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 315 Green Acres Rd, Fort Walton Beach, FL 32547-6132 | 2017-09-19 |
1255397170 | Renal Treatment Centers - Southeast, Lp | Clinic/Center | 1110 Hospital Rd, Suite A, Fort Walton Beach, FL 32547-6644 | 2006-04-21 |
1528584745 | Hampton Dialysis LLC | Clinic/Center | 1112 Hospital Rd, Fort Walton Beach, FL 32547-6742 | 2017-08-18 |
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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 |
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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 |
Find all providers with the same taxonomy |
City | FORT WALTON BEACH |
Zip Code | 32547 |
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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.