MYRTLE DIALYSIS LLC (NPI# 1487046652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487046652 |
| Entity Type | Organization |
| Organization Name | MYRTLE DIALYSIS LLC |
| Other Organization Name | HUDSON DIALYSIS |
| Practice Address |
421 Stageline Rd Hudson WI 54016-7848 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 6128527130 |
| Practice Fax Number | 8778507073 |
| Mailing Telephone | 6153416264 |
| Mailing Fax Number | 8002972925 |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | JOHN WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| 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 |
|---|---|
| Hudson Dialysis | Doing Business As Name - Organization |
| Street Address |
421 STAGELINE RD |
| City | HUDSON |
| State | WI |
| Zip Code | 54016-7848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921128 | Sara Lynn Henry | Occupational Therapy Assistant | 1320 Wisconsin St., Husdon, WI 54016 | 2018-02-06 |
| 1689003436 | Serving Hands Inc | Home Health | 1419 Boulder Court, Hudson, WI 54016 | 2013-11-02 |
| 1275973042 | Lisa Renee Haverly | Occupational Therapist | 477 Perch Lake Rd, Hudson, WI 54016 | 2013-06-26 |
| 1710320213 | Emily Ann Stevenson | Counselor | 901 4th St Ste 165, Hudson, WI 54016 | 2013-04-15 |
| 1083972954 | The Shurden Group | In Home Supportive Care | 2424 Monetary Blvd. #012, The Shurden Group Dba Comfort Keepers, Hudson, WI 54016 | 2012-04-30 |
| 1124305933 | Robert Michael Catlow-price | Massage Therapist | 131 Carmichael Road, Suite #202, Hudson, WI 54016 | 2011-11-08 |
| 1962780221 | Qin Chu | Acupuncturist | 1615 Maxwell Dr., Suite D, Hudson, WI 54016 | 2011-08-03 |
| 1124324231 | Hung Trieu Lieu | Acupuncturist | 1810 Crest View Dr Ste 4a, Hudson, WI 54016 | 2011-02-07 |
| 1912214966 | Sumac Residential LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 B Blue Jay Lane, Hudson, WI 54016 | 2010-09-10 |
| 1740593201 | Michelle Marie Young | Counselor | 2501 Hanley Road, Suite F, Eagle Valley Bank Building, Hudson, WI 54016 | 2010-07-26 |
| Find all providers in zip 54016 | ||||
| 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 |
|---|---|---|---|---|
| 1336552322 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 1901 Ward Ave, Suite 274, Hudson, WI 54016-2138 | 2014-06-06 |
| 1720055312 | Total Renal Care Inc | Clinic/Center | 14144 Nephron Ln, Hudson, FL 34667-6504 | 2006-03-02 |
| 1902837123 | Gulf Coast Kidney Center Inc | Clinic/Center | 14153 Yosemite Dr, Suite 102, Hudson, FL 34667-8060 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171599 | Dubuque Internal Medicine, PC | Clinic/Center | 190 N Orange St, Richland Center, WI 53581-2163 | 2020-10-13 |
| 1316570989 | Fresenius Medical Care Midwest Dialysis, LLC | Clinic/Center | 5125 W Morgan Ave, Greenfield, WI 53220-1540 | 2020-02-21 |
| 1992352082 | Fresenius Kidney Care Madison, LLC | Clinic/Center | 4600 American Pkwy Ste 102, Madison, WI 53718-8334 | 2019-08-22 |
| 1770040859 | Fresenius Medical Care Oshkosh, LLC | Clinic/Center | 2700 W 9th Ave Ste 101a, Oshkosh, WI 54904-7201 | 2019-02-26 |
| 1972008704 | Midwest Legacy Capital LLC | Clinic/Center | W4233 State Rd 54, Black Creek, WI 54106-8633 | 2018-03-26 |
| 1841792603 | Wisconsin Renal Care Group, L.L.C. | Clinic/Center | 17500 W Capitol Drive, Brookfield, WI 53045 | 2018-03-07 |
| 1992212286 | Total Renal Care Inc | Clinic/Center | 733 E Capitol Dr, Milwaukee, WI 53212 | 2018-01-08 |
| 1023527058 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 2831 Okeeffe Ave, Sun Prairie, WI 53590-7057 | 2017-09-21 |
| 1093234569 | Fresenius Medical Care Milwaukee, LLC | Clinic/Center | 2615 W Silver Spring Dr, Milwaukee, WI 53209-4219 | 2017-09-15 |
| 1770010928 | Total Renal Care Inc | Clinic/Center | 9127 N 76th St, Milwaukee, WI 53223-1905 | 2017-05-18 |
| Find all providers with the same taxonomy | ||||
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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.