LOCUSTON DIALYSIS, LLC (NPI# 1770141665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770141665 |
| Entity Type | Organization |
| Organization Name | LOCUSTON DIALYSIS, LLC |
| Other Organization Name | HARDEN DIALYSIS |
| Practice Address |
2105 Harden Blvd Lakeland FL 33803-5918 |
| Mailing Address |
5200 Virginia Way Brentwood TN 37027-7569 |
| Practice Telephone | 8632840534 |
| Practice Fax Number | 8632841140 |
| Mailing Telephone | 6153204593 |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2020-10-28 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 105379000 | 05 |
| Other Name | Type Code |
|---|---|
| Harden Dialysis | Doing Business As Name - Organization |
| Street Address |
2105 HARDEN BLVD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33803-5918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
| 1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
| 1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
| 1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
| 1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
| 1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
| 1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
| 1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
| 1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
| 1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
| Find all providers in zip 33803 | ||||
| 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 |
|---|---|---|---|---|
| 1295021095 | Total Renal Care Inc | Clinic/Center | 3187 Us Highway 98 N, Lakeland, FL 33805-2103 | 2011-06-21 |
| 1053599357 | Somerville Dialysis Center LLC | Clinic/Center | 9045 Highway 64, Ste 102, Lakeland, TN 38002-8394 | 2008-02-08 |
| 1649233206 | Total Renal Care Inc | Clinic/Center | 9160 Highway 64, Lakeland, TN 38002 | 2006-04-06 |
| 1376510487 | Dva Renal Healthcare Inc | Clinic/Center | 4774 S Florida Ave, Lakeland, FL 33813-2181 | 2006-03-07 |
| 1073580189 | Dva Healthcare Renal Care, Inc. | Clinic/Center | 515 E Bella Vista St, Lakeland, FL 33805-3005 | 2006-03-07 |
| 1871007229 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 1550 Lakeland Hills Blvd, Lakeland, FL 33805-3204 | 2017-11-21 |
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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 |
| 1750992814 | Swain Dialysis Renal Center | Clinic/Center | 1923 Nw 43rd St, Miami, FL 33142-4777 | 2020-08-12 |
| 1396355525 | Kidney Partners Coral Gables LLC | Clinic/Center | 835 Sw 37th Ave, Miami, FL 33135-4289 | 2020-08-03 |
| 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 | ||||
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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.