HEIDECK DIALYSIS LLC (NPI# 1831512003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831512003 |
| Entity Type | Organization |
| Organization Name | HEIDECK DIALYSIS LLC |
| Other Organization Name | ROSCOMMON DIALYSIS |
| Practice Address |
10450 N Roscommon Rd Roscommon MI 48653-9296 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9892750362 |
| Practice Fax Number | 9892750409 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2019-11-20 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1831512003 | 05 |
| Other Name | Type Code |
|---|---|
| Roscommon Dialysis | Doing Business As Name - Organization |
| Street Address |
10450 N ROSCOMMON RD |
| City | ROSCOMMON |
| State | MI |
| Zip Code | 48653-9296 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588106892 | Amanda Howe | Dental Hygienist | 135 Lake Street, Roscommon, MI 48653 | 2016-11-17 |
| 1861949471 | Christopher Michels | Contractor | 403 Peach Rd, Roscommon, MI 48653 | 2016-09-01 |
| 1114317336 | Valerie Louise Doebler | Occupational Therapy Assistant | 4450 E. Michigan Hwy., Roscommon, MI 48653 | 2015-01-26 |
| 1063664019 | Douglas C Mackintosh | Physical Therapist | 4079 West Marl Lake Dr, Roscommon, MI 48653 | 2008-10-21 |
| 1235354382 | Kevin B Rucinski Dds PC | Dentist | 188 Pine Bluffs, Roscommon, MI 48653 | 2007-04-16 |
| 1902021355 | Higgins Township Roscommon County Mich | Ambulance | 700 South Fifth Street, Roscommon, MI 48653 | 2007-04-13 |
| 1922172493 | Steven Carl Haertel | Chiropractor | 406 N 5th St, Roscommon, MI 48653 | 2006-11-17 |
| 1881775351 | Township Board of South Branch | Ambulance | 5245 N M-18, Roscommon, MI 48653 | 2006-10-18 |
| 1083712798 | Karrie Tieppo Williams | Dentist | 100 Sherwood Dr., Roscommon, MI 48653 | 2006-09-20 |
| 1386674661 | Rebecca L Smith | Counselor | 299h W Sunset, Roscommon, MI 48653 | 2006-07-03 |
| Find all providers in zip 48653 | ||||
| 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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|---|---|---|---|---|
| 1801497961 | Saint Marina Home Dialysis LLC | Clinic/Center | 26711 Northwestern Hwy Ste 125, Southfield, MI 48033-2170 | 2020-11-05 |
| 1144820226 | Heritage Home Dialysis LLC | Clinic/Center | 1580 N Leroy St Ste 6, Fenton, MI 48430-2801 | 2020-10-28 |
| 1386262350 | Delta Renal Care Pllc | Clinic/Center | 3981 Elizabeth Ave, Canton, MI 48188-7223 | 2020-07-07 |
| 1457973257 | Fms Owosso, LLC | Clinic/Center | 918 Corunna Ave, Owosso, MI 48867-3768 | 2020-05-14 |
| 1023650926 | Falmont Dialysis LLC | Clinic/Center | 37290 5 Mile Rd, Livonia, MI 48154-1848 | 2019-10-11 |
| 1487112942 | Michigan Dialysis Services, LLC | Clinic/Center | 275 N Canton Center Rd, Canton, MI 48187 | 2019-03-04 |
| 1487123600 | Concerto Michigan LLC | Clinic/Center | 14700 Farmington Rd Ste 108, Livonia, MI 48154-5462 | 2018-11-16 |
| 1245715291 | Brooksprings Dialysis, LLC | Clinic/Center | 2391 Fifteen Mile Rd, Sterling Heights, MI 48310 | 2018-09-26 |
| 1851886592 | Fms Rochester Hills, LLC | Clinic/Center | 26400 W 12 Mile Rd Ste 112, Southfield, MI 48034-1785 | 2018-06-26 |
| 1801399753 | Kasaskia Dialysis LLC | Clinic/Center | 18001 E 10 Mile Rd Ste B, Roseville, MI 48066-3803 | 2018-03-16 |
| 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.