ISD RENAL INC (NPI# 1982659264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982659264 |
| Entity Type | Organization |
| Organization Name | ISD RENAL INC |
| Other Organization Name | JACKSON NORTH DIALYSIS |
| Practice Address |
571 E Beasley Rd Ste A Jackson MS 39206-3042 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 6019571999 |
| Practice Fax Number | 6019563165 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2018-11-29 |
| 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 |
|---|---|---|---|
| MS | 00220365 | 05 |
| Other Name | Type Code |
|---|---|
| Jackson North Dialysis | Doing Business As Name - Organization |
| 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 |
571 E BEASLEY RD STE A |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-3042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841602257 | Mississippi Vascular Center, Pllc | Internal Medicine | 571 E Beasley Rd, Jackson, MS 39206-3042 | 2014-05-20 |
| 1174731590 | Matthews Florence Kirk | Social Worker | 571 E Beasley Rd, Suite -a, Jackson, MS 39206-3042 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| 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 |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1417481755 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 656 N State St, Jackson, MS 39202-3303 | 2017-04-13 |
| 1619274610 | Total Renal Care Inc | Clinic/Center | 46 Harts Bridge Road, Jackson, TN 38301-0000 | 2011-02-28 |
| 1770711509 | Fresenius Medical Care Kidney and Hypertension, LLC | Clinic/Center | 128 N Elm Ave, Jackson, MI 49202-3502 | 2009-07-01 |
| 1720220213 | Ara-jackson Dialysis LLC | Clinic/Center | 3 Acy Ave, Suite B, Jackson, OH 45640-9561 | 2009-03-30 |
| 1912166778 | Bio-medical Applications of Ohio Inc | Clinic/Center | 820 Veterans Dr, Jackson, OH 45640-2411 | 2008-06-06 |
| 1548489149 | Synergy Dialysis Associates, LLC | Clinic/Center | 500 Mccarty Ln, Jackson, OH 45640 | 2007-04-24 |
| 1245324045 | Rai Care Centers of Michigan I, LLC | Clinic/Center | 200 South East Ave., Jackson, MI 49201-2414 | 2006-10-03 |
| 1013019215 | Bio-medical Applications of Kentucky, Inc. | Clinic/Center | 1550 Highway 15 S Ste 30, Jackson, KY 41339-9221 | 2006-09-01 |
| 1518079359 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 2995 Race St, Jackson, LA 70748-5839 | 2006-08-31 |
| Find all providers in JACKSON | ||||
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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.