Excellence in Renal Care LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

EXCELLENCE IN RENAL CARE LLC

Practice address

1723 Amen Corner CT
Chesterton, IN 46304-3466

Phone

(219) 462-6001

NPI assigned

Dec 15, 2023

Organization subpart

No

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

Authorized official

Name

Lynn McDonald

Title

Credentialing

Phone

(219) 769-1670

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

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

• Aj Pampalone, D.O.

  • Nephrology Physician
  • Valparaiso, IN
  • NPI 1255337630
  Medicare reassignment NPD

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1023886306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 AMEN CORNER CT",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043466",
            "telephone_number": "219-462-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 AMEN CORNER CT",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043466",
            "telephone_number": "219-462-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENCE IN RENAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "219-769-1670"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Family Nurse Practitioners, LLC
• Flora Theresa Ellis, RPT
• Keith Ellis, PT
• Tracy Diane Evans
• Lauren Evenson
• Amanda Facer
• Angela Fain, RBT
• Jennifer Carol Fancher, FNP
• Samantha Farber
• Karen Marie Fatouros, LMHC

• Nephrology Physician in Chesterton, IN
• Providers in Chesterton, IN by specialty
• Nephrology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.