NPIMap

Organization Active NPI

Prodigy Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Johnstown, PA
National Provider Identifier
1023065554
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
PRODIGY DIALYSIS
Practice address
1111 Franklin St
Suite 220
Johnstown, PA 15905-4330
Phone
(814) 539-0798
Fax
(814) 536-4751
NPI assigned
May 29, 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
Dr. George Joseph Frem, MDNPI 1053315549
Title
Ceo & President
Phone
(814) 248-9269

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1111 Franklin St
Suite 220
Johnstown, PA 15905-4330

Mailing address

1111 Franklin St
Suite 220
Johnstown, PA 15905-4330
Phone (814) 539-0798

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023065554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 FRANKLIN ST",
            "address_2": "SUITE 220",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054330",
            "telephone_number": "814-539-0798",
            "fax_number": "814-536-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 FRANKLIN ST",
            "address_2": "SUITE 220",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054330",
            "telephone_number": "814-539-0798",
            "fax_number": "814-536-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FREM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO & PRESIDENT",
        "authorized_official_telephone_number": "814-248-9269",
        "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

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.