ISD RENAL INC (NPI# 1881192540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881192540 |
| Entity Type | Organization |
| Organization Name | ISD RENAL INC |
| Other Organization Name | COVINGTON TRACE DIALYSIS |
| Practice Address |
3999 Highway 190 East Service Rd Ste A Covington LA 70433-4914 |
| Mailing Address |
5200 Virginia Way L&c Department Brentwood TN 37027-7569 |
| Practice Telephone | 9852761998 |
| Practice Fax Number | 9852766856 |
| Mailing Telephone | 6153416764 |
| Mailing Fax Number | 8337816999 |
| Enumeration Date | 2018-01-29 |
| 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 |
|---|---|---|---|
| LA | 2489054 | 05 |
| Other Name | Type Code |
|---|---|
| Covington Trace Dialysis | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3999 Us Hwy 190 Service Rd, A, Covington, LA 704330004 | 9856643046 | 8666360565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295344307 | Isd Renal Inc | Clinic/Center | 1930 S Broad St Unit 7, Philadelphia, PA 19145-2328 | 2020-07-24 |
| 1225647332 | Isd Renal Inc | Clinic/Center | 230 N Broad St Bldg 12th, Philadelphia, PA 19102-1121 | 2020-07-24 |
| 1336758549 | Isd Renal Inc | Clinic/Center | 1300 W Lehigh Ave Ste 106, Philadelphia, PA 19132-2764 | 2020-07-24 |
| 1538793773 | Isd Renal Inc | Clinic/Center | 2317 Memorial Pkwy Sw Ste 105, Huntsville, AL 35801-5623 | 2020-02-26 |
| 1821646035 | Isd Renal Inc | Clinic/Center | 262 Broad St, Newark, NJ 07104-3809 | 2019-08-30 |
| 1245891670 | Isd Renal Inc | Clinic/Center | 100 W Forest Ave Ste G, Englewood, NJ 07631-4033 | 2019-06-26 |
| 1235795204 | Isd Renal Inc | Clinic/Center | 4952 Parkside Ave, Philadelphia, PA 19131 | 2019-05-15 |
| 1003390469 | Isd Renal Inc | Clinic/Center | 1843 Foreman Dr Ste 201, Cookeville, TN 38501-5933 | 2018-09-21 |
| 1174006662 | Isd Renal Inc | Clinic/Center | 2636 W Michigan St, Indianapolis, IN 46222-3727 | 2018-09-11 |
| 1619459682 | Isd Renal Inc | Clinic/Center | 620 Mall Blvd Ste E, Dyersburg, TN 38024-1649 | 2018-09-05 |
| Street Address |
3999 HIGHWAY 190 EAST SERVICE RD STE A |
| City | COVINGTON |
| State | LA |
| Zip Code | 70433-4914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790301018 | Caroline K. Wilson | Speech-Language Pathologist | 19105 Sandy Lane Suite A, Covington, LA 70433 | 2020-06-23 |
| 1568092013 | Tracy T Aljabi | Nurse Practitioner | 648 Crestwood Dr., Covington, LA 70433 | 2020-01-23 |
| 1093365462 | Maria Robert Hebrock | Marriage & Family Therapist | 71338 La-21, Suite 101, Covington, LA 70433 | 2019-09-17 |
| 1750930806 | Terry Fink Troxler | Speech-Language Pathologist | 521 Covington Point Dr, Covington, LA 70433 | 2019-09-10 |
| 1780231589 | Margaret Nordness Favre | Behavioral Analyst | 3999 Us-190, Covington, LA 70433 | 2019-08-26 |
| 1881241180 | Jennifer Ann Bacile | Counselor | 604 E 15th Street, Covington, LA 70433 | 2019-08-21 |
| 1356906689 | Moving and Caring Transportation LLC | Non-emergency Medical Transport (VAN) | 251 Vintage Drive, Covington, LA 70433 | 2019-05-02 |
| 1780153874 | Nga Endoscopy Center LLC | Clinic/Center | 7015 Hwy 190 E Service Road Suite 103, Covington, LA 70433 | 2018-11-19 |
| 1831667229 | Geauxprodme | Durable Medical Equipment & Medical Supplies | 1304 Champagne Street, Covington, LA 70433 | 2018-11-05 |
| 1376037994 | Pamela Ann Bernabo | Specialist/Technologist, Other | 80 Maison Drive, Covington, LA 70433 | 2018-06-18 |
| Find all providers in zip 70433 | ||||
| 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 |
|---|---|---|---|---|
| 1952898801 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 117 Mall Rd, Covington, VA 24426-2413 | 2018-04-17 |
| 1508281817 | Shone Dialysis LLC | Clinic/Center | 10132 Carlin Dr, Covington, GA 30014-3651 | 2014-02-24 |
| 1063524825 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 170 Greenbrier Blvd, Covington, LA 70433-7233 | 2006-08-31 |
| 1619089422 | Bio-medical Applications of Georgia Inc. | Clinic/Center | 11415 Brown Bridge Rd, Covington, GA 30016-3360 | 2006-08-31 |
| 1023120854 | Bio-medical Applications of Georgia Inc | Clinic/Center | 7215 Industrial Blvd Ne, Covington, GA 30014-6329 | 2006-08-31 |
| 1114949005 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 2047 Highway 51 S, Covington, TN 38019-3631 | 2006-07-23 |
| 1699720011 | Dsi Renal Inc | Clinic/Center | 4179 Baker St Ne, Covington, GA 30014-1405 | 2006-05-24 |
| 1407810617 | Dva Healthcare Renal Care Inc | Clinic/Center | 2504 Valley Ridge Rd, Covington, VA 24426-6339 | 2006-04-14 |
| 1215990759 | Dva Healthcare Renal Care Inc | Clinic/Center | 107 Tennessee Ave, Covington, TN 38019-3902 | 2006-04-07 |
| 1053370106 | Renal Treatment Centers Southeast Lp | Clinic/Center | 210 Greenbriar Blvd, Covington, LA 70433-7235 | 2006-03-18 |
| Find all providers in COVINGTON | ||||
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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.