Hemodialysis Assoc PC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

HEMODIALYSIS ASSOC PC

Practice address

3335 S Crater Rd
Petersbury, VA 23805

Phone

(804) 862-5261

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Frederick Ivan Ende, MDNPI 1497855373

Title

President

Phone

(804) 861-9555

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frederick Ivan Ende, M.D.

  • Internal Medicine Physician
  • Petersburg, VA
  • NPI 1497855373
  NPD (past) Authorized official
• Mark Ende, M.D.

  • Internal Medicine Physician
  • Petersburg, VA
  • NPI 1528152824
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1013004043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 SANDHURST DR",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238057862",
            "telephone_number": "804-861-9555",
            "fax_number": "804-861-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 S CRATER RD",
            "city": "PETERSBURY",
            "state": "VA",
            "postal_code": "23805",
            "telephone_number": "804-862-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEMODIALYSIS ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "ENDE",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-861-9555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "005522",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8915229",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.