KIDNEY INSTITUTE OF WISCONSIN, LLC (NPI# 1831262674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831262674 |
| Entity Type | Organization |
| Organization Name | KIDNEY INSTITUTE OF WISCONSIN, LLC |
| Practice Address |
5650 N Green Bay Ave Suite 150 Glendale WI 53209-4446 |
| Mailing Address |
2100 Central Ave Suite 201 Boulder CO 80301-2838 |
| Practice Telephone | 4144315960 |
| Practice Fax Number | 4144340359 |
| Mailing Telephone | 3037857523 |
| Mailing Fax Number | 3034448639 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | HERBERT S LAWSON (CFO) |
| Authorized Official Telephone | 3037857521 |
| 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 |
|---|---|---|---|
| WI | 42059400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891866380 | Kidney Institute of Wisconsin, LLC | Clinic/Center | 10130 W Appleton Ave, Milwaukee, WI 53225-2579 | 2006-11-13 |
| Street Address |
5650 N GREEN BAY AVE SUITE 150 |
| City | GLENDALE |
| State | WI |
| Zip Code | 53209-4446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265406516 | Kamal Amin | Internal Medicine | 5650 N Green Bay Ave, Suite 100, Glendale, WI 53209-4446 | 2006-02-14 |
| 1235457508 | Total Renal Care Inc | Clinic/Center | 5650 N Green Bay Ave, Suite 150, Glendale, WI 53209-4449 | 2010-05-12 |
| 1871765859 | Anushayanthan Alfred | Internal Medicine | 5650 N Green Bay Ave, Suite 100, Glendale, WI 53209-4446 | 2008-03-30 |
| 1881620292 | Ramadevi Balija | Pediatrics | 5650 N Green Bay Ave, Suite 210, Glendale, WI 53209-4446 | 2006-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238253 | Niajcia Brookshire | Counselor | 3900 W Brown Deer Rd Suite 200, Brown Deer, WI 53209 | 2019-08-01 |
| 1740751015 | Mary Fuller | Home Health Aide | 3043 N 29th St., Milwaukee, WI 53209 | 2018-12-16 |
| 1154869410 | Jacksonscott2 | Skilled Nursing Facility | 4573 N. 22nd Street, Milwaukee, WI 53209 | 2017-02-07 |
| 1669910469 | Dimera House | In Home Supportive Care | 4002 W Fairount Ave, Milwaukee, WI 53209 | 2017-02-01 |
| 1891248340 | Amy L May | Nurse Practitioner | 3303 W Good Hope Rd, Milwaukee, WI 53209 | 2016-08-02 |
| 1871980193 | Alan R Rosenthal | Pharmacist | 6930 N Beech Tree Dr, Milwaukee, WI 53209 | 2015-04-24 |
| 1104212380 | Reema Shah | Student in an Organized Health Care Education/Training Program | 2400 W. Villard Ave, Milwaukee, WI 53209 | 2015-04-14 |
| 1336534403 | Robert Michael Kitsis | Family Medicine | 9252 N Green Bay Rd Fl 2, Brown Deer, WI 53209 | 2015-04-05 |
| 1962891994 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Public Health or Welfare | 8330 North Teutonia Ave Suite 103, Brown Deer, WI 53209 | 2015-01-14 |
| 1548659634 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Early Intervention Provider Agency | 8330 North Teutonia Avenue Suite 103, Brown Deer, WI 53209 | 2015-01-13 |
| Find all providers in zip 53209 | ||||
| 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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| 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.