SOMERVILLE DIALYSIS CENTER LLC (NPI# 1730346933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730346933 |
| Entity Type | Organization |
| Organization Name | SOMERVILLE DIALYSIS CENTER LLC |
| Other Organization Name | SOMERVILLE DIALYSIS |
| Practice Address |
12475 Us Highway 64 Somerville TN 38068-6029 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9014661919 |
| Practice Fax Number | 9014661930 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2020-05-16 |
| Authorized Official Name | JOHN D 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 0442683 | 05 | |
| AR | 176950134 | 05 | |
| MS | 05677019 | 05 |
| Other Name | Type Code |
|---|---|
| Somerville Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053599357 | Somerville Dialysis Center LLC | Clinic/Center | 9045 Highway 64, Ste 102, Lakeland, TN 38002-8394 | 2008-02-08 |
| Street Address |
12475 US HIGHWAY 64 |
| City | SOMERVILLE |
| State | TN |
| Zip Code | 38068-6029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063850477 | Paula Lenore Walker | Nurse Practitioner | 25 Woodbridge, Suite A, Somerville, TN 38068 | 2013-06-07 |
| 1902026107 | Alliance Health Services, Inc | Home Health | 201 Lakeview Dr, Suite B, Somerville, TN 38068 | 2007-04-27 |
| 1730239997 | State of Tennessee | Public Health or Welfare | 90 Yum Yum Road, Somerville, TN 38068 | 2007-01-11 |
| 1366514697 | Cynthia D Elder | Pharmacy Technician | 13092 North Main Street, Summerville, TN 38068 | 2006-11-14 |
| 1275612053 | Bessie M Hoskins | Pharmacy Technician | 13092 North Main, Somerville, TN 38068 | 2006-11-03 |
| 1245319797 | Deborah Louise Davis | Pharmacy Technician | 8885 La Grange Rd, Somerville, TN 38068 | 2006-11-03 |
| 1891876868 | John David Cima | Dentist | 13190 N. Main St, Somerville, TN 38068 | 2006-10-18 |
| 1750478277 | Marie Middlecoff Stevens | Pharmacist | 13092 N Main Street, Super Drugs, Somerville, TN 38068 | 2006-10-06 |
| 1588675276 | Wilder Clinic | Family Medicine | 201 Lake View, Ste A Wilder Clinic, Sunerville, TN 38068 | 2006-08-10 |
| 1588687644 | Freds Stores of Tennessee Inc | Pharmacy | Highway 64 West, Somerville, TN 38068 | 2006-07-26 |
| Find all providers in zip 38068 | ||||
| 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 |
|---|---|---|---|---|
| 1326590548 | Physicians Dialysis Somerville, LLC | Clinic/Center | 1 Route 206, North, Somerville, NJ 08876 | 2016-11-04 |
| 1124121405 | Renal Center of Somerville, LLC | Clinic/Center | 1 Route 206 North, Somerville, NJ 08876-4143 | 2006-09-05 |
| 1972536357 | Dialysis Clinic Inc. | Clinic/Center | 645 Broadway, Somerville, MA 02145-2528 | 2006-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831736438 | Fresenius Medical Care Cookeville, LLC | Clinic/Center | 117 N Hickory Ave Ste 100, Cookeville, TN 38501-2424 | 2019-12-03 |
| 1245872829 | Pure Life Renal of Cool Springs, LLC | Clinic/Center | 1648 Westgate Cir Ste 100, Brentwood, TN 37027-8019 | 2019-10-15 |
| 1386298560 | Mattapan Dialysis LLC | Clinic/Center | 5144 Riverdale Rd Ste 103, Memphis, TN 38141-0271 | 2019-07-26 |
| 1114480761 | Avail Southeast Kidney Care LLC | Clinic/Center | 2008 Brookside Dr Ste 100, Kingsport, TN 37660-4640 | 2019-04-10 |
| 1609337161 | Dialysis Clinic Inc | Clinic/Center | 5653 Frist Blvd Ste 334, Hermitage, TN 37076-2064 | 2019-03-27 |
| 1972062669 | Dialyze Direct Tn, LLC | Clinic/Center | 2600 Thousand Oaks Blvd Ste 1400, Memphis, TN 38118-2401 | 2019-03-13 |
| 1336610757 | Fresenius Medical Care Columbia Franklin, LLC | Clinic/Center | 8048 Station Hill Drive, Spring Hill, TN 37174 | 2018-12-11 |
| 1770052888 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 6085 Arbury Way, Ooltewah, TN 37363 | 2018-11-19 |
| 1164907929 | Fresenius Medical Care Sandy River, LLC | Clinic/Center | 57 Commerce St, Paris, TN 38242-4917 | 2018-09-27 |
| 1003390469 | Isd Renal Inc | Clinic/Center | 1843 Foreman Dr Ste 201, Cookeville, TN 38501-5933 | 2018-09-21 |
| Find all providers with the same taxonomy | ||||
| City | SOMERVILLE |
| Zip Code | 38068 |
Please comment or provide details below to improve the information on SOMERVILLE DIALYSIS CENTER 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.