Liberty Dialysis - Lakeland LLC

Primary specialty

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

Legal business name

LIBERTY DIALYSIS - LAKELAND LLC

Practice address

3772 Hollywood Rd
Saint Joseph, MI 49085-9550

Phone

(269) 428-7474

NPI assigned

Mar 25, 2010

Organization subpart

No

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

Authorized official

Name

Ryan Pardo

Title

Vice President

Phone

(206) 236-5001

Specialties & licenses 1

Addresses

Other names 1

• Liberty Dialysis at Lakeland Royalton Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• National Medical Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bristol, TN
  • NPI 1477570117

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500422400000",
    "number": "1013231620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 SE 27TH ST",
            "address_2": "SUITE 200",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859550",
            "telephone_number": "269-428-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - LAKELAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2017-07-19",
        "status": "A",
        "authorized_official_last_name": "PARDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "206-236-5001"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Dialysis at Lakeland Royalton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandra Marie Lenardson
• Ivelisse E Leonor, FAMILY NURSE PRACTIO
• Ashley Lepak, D.O.
• Eric P Lester, M.D.
• Samuel Edward Alpha Lewin, LLPC
• Richard Michael Liebelt, RN
• Angela Lies
• Lighthouse Behavioral Health, PLLC
• Lighthouse Concierge LLC
• Lighthouse Counseling

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.