SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC (NPI# 1790969681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790969681 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC |
| Other Organization Name | PHOENIX HOME DIALYSIS |
| Practice Address |
20325 N 51st Ave Bldg 11 Ste 184 Glendale AZ 85308-5674 |
| Mailing Address |
5200 Virginia Way Ste 400 L&c Brentwood TN 37027-7569 |
| Practice Telephone | 6235333836 |
| Practice Fax Number | 6235334033 |
| Mailing Telephone | 6153204435 |
| Mailing Fax Number | 3032097821 |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2008-01-10 |
| Authorized Official Name | THOMAS O USILTON JR. (SR VICE PRESIDENT) |
| Authorized Official Telephone | 7705417922 |
| 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 |
|---|---|
| Phoenix Home Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932688256 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 926 E Mcdowell Rd Ste 100, Phoenix, AZ 85006-2503 | 2018-08-08 |
| 1770714701 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 975 W Chandler Heights Rd, Unit 101, Chandler, AZ 85248-5724 | 2009-08-08 |
| 1770758526 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 4845 W Mcdowell Rd, Ste 10a, 20a, 30a, Phoenix, AZ 85035-4076 | 2008-04-23 |
| 1164948121 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 1521 E Tangerine Rd Ste 101, Oro Valley, AZ 85755-6214 | 2017-08-21 |
| 1821344581 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 301 S Power Rd, Ste 104, Mesa, AZ 85206-5243 | 2012-07-31 |
| 1093071821 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 811 N Tegner St, Suites 101, 103, 105, 107, Wickenburg, AZ 85390-5409 | 2012-04-05 |
| 1700059227 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 1134 E University Dr, Ste 101, Mesa, AZ 85203-8048 | 2008-04-04 |
| 1578746277 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 2149 E Warner Rd, Ste 110, Tempe, AZ 85284-3496 | 2007-12-17 |
| 1093998767 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 5222 E Baseline Rd, Ste 104, Gilbert, AZ 85234-2963 | 2007-12-17 |
| 1033392709 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 8410 W Thomas Rd, Ste 100 Bldg 1, Phoenix, AZ 85037-3356 | 2007-12-17 |
| Street Address |
20325 N 51ST AVE BLDG 11 STE 184 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85308-5674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386643641 | Joseph Frank Raynak | Family Medicine | 20325 N 51st Ave, Suite 170, Glendale, AZ 85308-5674 | 2005-07-19 |
| 1801494208 | Tara Nicole Kirkpatrick | Dietitian, Registered | 20325 N 51st Ave, Bldg 9, Suite 166, Glendale, AZ 85308 | 2020-10-16 |
| 1407318298 | Az Surgery Center, LLC | Surgery | 20325 N 51st Ave, Bldg 7, Ste 156, Glendale, AZ 85308 | 2019-04-02 |
| 1467914259 | Adobe Ent & Allergy, LLC | Otolaryngology | 20325 N 51st Ave, Bldg 7, Ste 154, Glendale, AZ 85308 | 2019-04-02 |
| 1003308487 | Kimberly Nishiyama | Dietetic Technician, Registered | 20325 N 51st Ave, Glendale, AZ 85308-5674 | 2018-06-01 |
| 1700323524 | Karla Guadalupe Cabrera | Nurse Practitioner | 20325 N 51st Ave, Bldg 8 Ste 160, Glendale, AZ 85308-5674 | 2017-01-31 |
| 1881045375 | Tristine Bogle | Dietitian, Registered | 20325 N 51st Ave, Ste 166, Glendale, AZ 85308-4624 | 2016-06-26 |
| 1487019246 | Desert Dreams Anesthesia, Pllc | Anesthesiology | 20325 N 51st Ave, Suite 160, Glendale, AZ 85308-5674 | 2015-12-22 |
| 1548647936 | Yvonne Mclemore | Nurse Practitioner | 20325 N 51st Ave, Suite 160, Glendale, AZ 85308-5674 | 2015-05-05 |
| 1003225608 | Martha Reed | Homeopath | 20325 N 51st Ave, Suite 112, Glendale, AZ 85308-5674 | 2014-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972102572 | Inspire Wellness and Pelvic Health | Clinic/Center | 5940 W Union Hills Dr Ste D280, Glendale, AZ 85308 | 2020-10-23 |
| 1669081709 | Michelle Yoakim | Student in an Organized Health Care Education/Training Program | 19555 N 59th Avenuue, Glendale, AZ 85308 | 2020-07-24 |
| 1033742291 | Kaitlyn Marie Shannon | Dietitian, Registered | 20325 North 51st Avenue, Building 9, Suite 166, Glendale, AZ 85308 | 2020-02-17 |
| 1295377687 | Serenity Preserved Counseling Pllc | Counselor | 21448 N. 75th Avenue Ste G, Glendale, AZ 85308 | 2019-10-17 |
| 1013567023 | Caitlyn Heredia | Student in an Organized Health Care Education/Training Program | 18330 N 79th Avenue, Apartment 1070, Glendale, AZ 85308 | 2019-09-12 |
| 1770141061 | Sydney Dangelo | Student in an Organized Health Care Education/Training Program | 7454 W Denaro Dr, Glendale, AZ 85308 | 2019-05-31 |
| 1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
| 1831678341 | Ayat Mahdi Obeidi | Dentist | 19420 N 59th Ave Ste D400, Glendale, AZ 85308 | 2018-08-07 |
| 1720580038 | Lifeline Professional Counseling Services, Inc | Clinic/Center | 17235 N 75th Ave Suite F-100, Glendale, AZ 85308 | 2018-03-02 |
| 1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
| Find all providers in zip 85308 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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|---|---|---|---|---|
| 1437613916 | Premier Home Dialysis Services | Clinic/Center | 20118 N 67th Ave Ste 300-527, Glendale, AZ 85308-4621 | 2019-01-29 |
| 1538666045 | Bio-medical Applications of Arizona LLC | Clinic/Center | 6622 N 91st Ave Ste 120, Glendale, AZ 85305-2512 | 2018-04-11 |
| 1538661483 | Bio-medical Applications of Arizona LLC | Clinic/Center | 6622 N 91st Ave Ste 210, Glendale, AZ 85305-2569 | 2018-03-07 |
| 1174043046 | Yards Dialysis LLC | Clinic/Center | 6850 San Fernando Rd, Glendale, CA 91201-1642 | 2017-06-22 |
| 1396111886 | Fresenius Medical Care Glendale, LLC | Clinic/Center | 623 S Central Ave, Glendale, CA 91204 | 2015-08-19 |
| 1962888560 | Genesis Services, LLC | Clinic/Center | 7407 88th St, Glendale, NY 11385-7951 | 2015-08-05 |
| 1578947636 | Bio-medical Applications of Arizona LLC | Clinic/Center | 4407 W Peoria Ave, Glendale, AZ 85302-2036 | 2015-07-17 |
| 1437241403 | Glendale Nephrology Services, LLC | Clinic/Center | 1427 S Glendale Ave, Glendale, CA 91205-3313 | 2006-09-28 |
| 1598877490 | Bio-medical Applications of Arizona, LLC | Clinic/Center | 16844 N 59th Ave, Glendale, AZ 85306-1118 | 2006-08-31 |
| 1851403752 | Bio-medical Applications of Arizona, LLC | Clinic/Center | 5957 W Northern Ave Ste 108, Glendale, AZ 85301-7825 | 2006-08-31 |
| Find all providers in GLENDALE | ||||
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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.