Dialysis Management Group LLC

Primary specialty

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

Legal business name

DIALYSIS MANAGEMENT GROUP LLC

Practice address

101 Main Street
Porcupine, SD 57772

Phone

(605) 718-0391

NPI assigned

Sep 22, 2006

Last updated

Aug 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Louis C Raymond, MD

Title

Medical Director

Phone

(605) 718-0391

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

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

• Dialysis Management Group LLC

  dba Porcupine Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Porcupine, SD
  • NPI 1922318666

  Member Of

  NPD member

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249862400000",
    "number": "1033219035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "city": "PORCUPINE",
            "state": "SD",
            "postal_code": "57772",
            "telephone_number": "605-718-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN STREET",
            "city": "PORCUPINE",
            "state": "SD",
            "postal_code": "57772",
            "telephone_number": "605-718-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS MANAGEMENT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2009-08-10",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "605-718-0391",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400390",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chanku Waste Dental LLC
• Dialysis Management Group LLC (Porcupine Dialysis Center)
• Alicia Claire Mousseau, PH.D.
• Pine Ridge Indian Health Service Hospital
• Tadd Evan Sharp-Bowman

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Porcupine, SD
• Providers in Porcupine, SD by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.