FIDELITY HOME DIALYSIS CORPORATION (NPI# 1447640917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447640917 |
| Entity Type | Organization |
| Organization Name | FIDELITY HOME DIALYSIS CORPORATION |
| Practice Address |
9421 W Markham St Little Rock AR 72205-2240 |
| Practice Telephone | 5012173888 |
| Practice Fax Number | 5012173886 |
| Mailing Telephone | 5012173888 |
| Mailing Fax Number | 5012173886 |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2016-12-16 |
| Authorized Official Name | STEVE FICKLIN (ADMINISTRATOR) |
| Authorized Official Telephone | 5012173888 |
| 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 |
|---|---|---|---|
| AR | MEDICARE | 042593 | 01 |
| Street Address |
9421 W MARKHAM ST |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-2240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| 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 |
|---|---|---|---|---|
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| 1922346147 | Dialysis Clinic Inc. | Clinic/Center | 2800 W 10th St, Suite 510, Little Rock, AR 72204-2206 | 2013-01-23 |
| 1023313988 | Capes Dialysis LLC | Clinic/Center | 2 Lile Court, Ste 102-a, Little Rock, AR 72205-6241 | 2011-01-24 |
| 1376516039 | Dva Renal Healthcare Inc | Clinic/Center | 6 Freeway Dr, Suite 100, Little Rock, AR 72204-2486 | 2006-02-10 |
| 1679845580 | Bio-medical Applications of Arkansas, Inc. | Clinic/Center | 5320 W 12th St, Little Rock, AR 72204-1859 | 2012-02-08 |
| 1619274735 | Westside Dialysis Unit LLC | Clinic/Center | 1515 Kanis Park Dr, Suite A, Little Rock, AR 72205-4569 | 2011-02-25 |
| 1821100728 | Little Rock Dialysis Inc | Clinic/Center | 10310 W Markham St, Suite 100, Little Rock, AR 72205-2175 | 2006-08-31 |
| 1306876925 | Baptist Health | Clinic/Center | 9601 Baptist Health Drive, Little Rock, AR 72205 | 2006-07-03 |
| 1790728079 | St. Vincent Infirmary Medical Center | Clinic/Center | 2 Saint Vincent Cir, Little Rock, AR 72205-5423 | 2006-06-14 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72205 |
Please comment or provide details below to improve the information on FIDELITY HOME DIALYSIS CORPORATION.
| 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.