PERITONEAL DIALYSIS CONCEPTS INC. (NPI# 1861424707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861424707 |
| Entity Type | Organization |
| Organization Name | PERITONEAL DIALYSIS CONCEPTS INC. |
| Other Organization Name | HOME DIALYSIS OF DAYTON |
| Practice Address |
1 Elizabeth Pl. 627 Edwin C Moses Blvd Suite 2b Dayton OH 45417-1445 |
| Mailing Address |
30100 Telegraph Rd Suite 200 Bingham Farms MI 48025-4516 |
| Practice Telephone | 9372757402 |
| Practice Fax Number | 9374243581 |
| Mailing Telephone | 2487230224 |
| Mailing Fax Number | 2486427852 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2009-09-09 |
| Authorized Official Name | MR. DAVID F SHEPERD (VICE PRESIDENT) |
| Authorized Official Telephone | 2486425038 |
| 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 |
|---|---|---|---|
| OH | 0133439 | 05 | |
| OH | ANTHEM | 000000002891 | 01 |
| UNITED HEALTH CARE | 6800191 | 01 |
| Other Name | Type Code |
|---|---|
| Home Dialysis of Dayton | Other Name - Individual/Organization |
| Street Address |
1 ELIZABETH PL. 627 EDWIN C MOSES BLVD SUITE 2B |
| City | DAYTON |
| State | OH |
| Zip Code | 45417-1445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329504 | Kanika Crowder | Home Health Aide | 5964 Hoover Ave, Dayton, OH 45417 | 2020-03-03 |
| 1427510510 | Michael S Hatesohl | Student in an Organized Health Care Education/Training Program | 627 South Edwin C. Moses Blvd., East Medical Plaza, 1st Floor, Dayton, OH 45417 | 2019-04-05 |
| 1205313350 | Latonda T Brewer | Home Health Aide | 3900 Cone Ct, Dayton, OH 45417 | 2018-07-22 |
| 1205326048 | Diane Fillmore | Case Manager/Care Coordinator | 1818 West Main Street, Dayton, OH 45417 | 2018-05-17 |
| 1295222941 | Zainab Saherwala | Student in an Organized Health Care Education/Training Program | 627 S. Edwin C. Moses, East Medical Plaza, 1st Floor, Dayton, OH 45417 | 2018-04-18 |
| 1013430123 | Bridgette Elizabeth Quinlin | Counselor | 4104 Germantown St, Dayton, OH 45417 | 2017-07-20 |
| 1083144679 | Tadesha Marie Gay | Licensed Practical Nurse | 4748 Ericson Ave, Dayton, OH 45417 | 2017-06-15 |
| 1386180099 | Bio-medical Applications of Ohio, Inc. | Clinic/Center | 821 S Edwin C Moses Blvd, Dayton, OH 45417 | 2017-01-19 |
| 1770039760 | Jamie E Denlinger | Social Worker | 1 Elizabeth Pl Fl 3, Dayton, OH 45417 | 2016-08-30 |
| 1780069823 | Care4us Behavioral Health Center, LLC | Community/Behavioral Health | 1 Elizabeth Place, Ste 1170, Dayton, OH 45417 | 2015-07-29 |
| Find all providers in zip 45417 | ||||
| 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 |
|---|---|---|---|---|
| 1386180099 | Bio-medical Applications of Ohio, Inc. | Clinic/Center | 821 S Edwin C Moses Blvd, Dayton, OH 45417 | 2017-01-19 |
| 1316481427 | Total Renal Care Inc | Clinic/Center | 5680 Salem Bend Dr., Dayton, OH 45426-1462 | 2016-12-08 |
| 1336682707 | Isd Renal Inc | Clinic/Center | 2808 Germantown St, Dayton, OH 45417-4134 | 2016-12-02 |
| 1427399369 | Lakeshore Dialysis LLC | Clinic/Center | 4750 N Main St, Dayton, OH 45405-5021 | 2013-03-01 |
| 1710281464 | Total Renal Care Inc | Clinic/Center | 455 Turner Rd Ste B, Dayton, OH 45415-3630 | 2011-01-10 |
| 1194837088 | Bio-medical Applications of Texas, Inc. | Clinic/Center | 1003 N Cleveland St, Dayton, TX 77535-2131 | 2006-08-31 |
| 1285667667 | Dialysis Clinic Inc. | Clinic/Center | 230 White Oak Rd, Dayton, TN 37321-5200 | 2006-07-08 |
| 1255312526 | Dialysis Centers of Dayton, LLC | Clinic/Center | 1431 Business Center Ct, Dayton, OH 45410-3300 | 2005-11-14 |
| 1861005241 | Fresenius Medical Care Centerville Home, LLC | Clinic/Center | 7211 Shull Rd, Dayton, OH 45424-1234 | 2020-08-26 |
| 1962956672 | Total Renal Care Inc | Clinic/Center | 1431 Business Center Ct, Dayton, OH 45410-3300 | 2016-08-10 |
| Find all providers in DAYTON | ||||
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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.