SHAWANO DIALYSIS, LLC (NPI# 1720552110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720552110 |
| Entity Type | Organization |
| Organization Name | SHAWANO DIALYSIS, LLC |
| Practice Address |
13859 Village Place Dr Midlothian VA 23114-3503 |
| Mailing Address |
5200 Virginia Way L & C Department Brentwood TN 37027-7569 |
| Practice Telephone | 8043782170 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-18 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER, TREASURER) |
| 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 |
| Other Name | Type Code |
|---|---|
| James River Home Dialysis | Doing Business As Name - Organization |
| Street Address |
13859 VILLAGE PLACE DR |
| City | MIDLOTHIAN |
| State | VA |
| Zip Code | 23114-3503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122162 | Jotava | In Home Supportive Care | 1607 Titanium Avenue, 202, Midlothian, VA 23114 | 2020-10-20 |
| 1104393735 | Shelley Hurwitz | Occupational Therapist | 13800 Bon Secours Drive, Midlothian, VA 23114 | 2018-11-01 |
| 1316412182 | Snehal Manmeet Mahajan | Physical Therapist | 13800 Bon Secours Dr., Midlothian, VA 23114 | 2018-10-09 |
| 1154814796 | Bon Secours St Francis Medical Center Inc. | Clinic/Center | 13700 St Francis Blvd Ste 105, Midlothian, VA 23114 | 2018-06-08 |
| 1023516630 | Leah Reed | Occupational Therapist | 13800 Bon Secours Dr, Midlothian, VA 23114 | 2018-01-29 |
| 1689122012 | Momentum Counseling and Wellness LLC | Social Worker | 431 Walton Park Road, Midlothian, VA 23114 | 2016-09-14 |
| 1750765996 | Arlene Roper | Physical Therapy Assistant | 1700 Redbourne Ct, Apt 101, Midlothian, VA 23114 | 2015-07-17 |
| 1518353937 | Tamaika Floy | Podiatrist | 611 Watkins Centre Pkwy Ste 170, Midlothian, VA 23114 | 2015-04-13 |
| 1760790489 | Markita Wolf | Psychologist | 831 Grove Rd Ste C, Midlothian, VA 23114 | 2010-09-15 |
| 1306153119 | Jacinda Beth Chaisson | Physical Therapist | 13700 St. Francis Blvd., Suite 103, Midlothian, VA 23114 | 2010-09-01 |
| Find all providers in zip 23114 | ||||
| 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 |
|---|---|---|---|---|
| 1518094192 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 2312 Colony Crossing Pl, Midlothian, VA 23112-4280 | 2007-02-28 |
| 1073577128 | Dva Healthcare Renal Care Inc | Clinic/Center | 14281 Midlothian Tpke Bldg B, Midlothian, VA 23113-6560 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497363253 | Fresenius Medical Care Kempsville Home, LLC | Clinic/Center | 6161 Kempsville Cir Ste B, Norfolk, VA 23502-3932 | 2020-07-17 |
| 1760004360 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 7525 Tidewater Dr Ste 37, Norfolk, VA 23505-3700 | 2020-05-18 |
| 1871113746 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 165 Market St Ste 6, Onancock, VA 23417-4233 | 2020-04-21 |
| 1447889399 | Legacy Dialysis of Virginia | Clinic/Center | 211 Gibson St Nw Ste 209, Leesburg, VA 20176-2115 | 2020-04-03 |
| 1457907917 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 570 Westgate Shopping Ctr, Bedford, VA 24523-2643 | 2019-08-12 |
| 1306492848 | Renal Treatment Centers- Mid-atlantic, Inc. | Clinic/Center | 145 Holt Garrison Pkwy Ste 340, Danville, VA 24540-5956 | 2019-08-12 |
| 1043873664 | Branbur Dialysis LLC | Clinic/Center | 4650 Puddledock Rd, Prince George, VA 23875-1235 | 2019-04-18 |
| 1811454226 | Mohansic Dialysis, LLC | Clinic/Center | 8123 Richmond Hwy, Alexandria, VA 22309-3613 | 2019-02-22 |
| 1528533171 | Gansett Dialysis, LLC | Clinic/Center | 8605 Westwood Center Dr Ste 100, Vienna, VA 22182-2231 | 2018-10-10 |
| 1518449784 | Renal Treatment Centers - Mid-atlantic Inc | Clinic/Center | 19980 Highland Vista Dr Ste 100, Ashburn, VA 20147-4189 | 2018-09-04 |
| Find all providers with the same taxonomy | ||||
| City | MIDLOTHIAN |
| Zip Code | 23114 |
Please comment or provide details below to improve the information on SHAWANO 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.