NPIMap

Organization Active NPI

Greater Lafayette Health Services

Doing business as White County Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Monticello, IN
National Provider Identifier
1003915455
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
GREATER LAFAYETTE HEALTH SERVICES
Doing business as
White County Dialysis
Practice address
1017 O Connor Blvd
Monticello, IN 47960-1600
Phone
(574) 583-3664
NPI assigned
Sep 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Terrance E Wilson
Title
Chief Executive Officer
Phone
(765) 423-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X IN Primary

Addresses

Primary practice location

1017 O Connor Blvd
Monticello, IN 47960-1600

Mailing address

1017 O Connor Blvd
Monticello, IN 47960-1600
Phone (574) 583-3664

Other names 1

  • White County Dialysis Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Franciscan Health Lafayette24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

1017 O Connor Blvd
Monticello, IN 47960
Phone (574) 583-3664

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003915455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 O CONNOR BLVD",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479601600",
            "telephone_number": "574-583-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 O CONNOR BLVD",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479601600",
            "telephone_number": "574-583-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LAFAYETTE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "765-423-6161",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White County Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.