NPIMap

Organization Active NPI

Garfield Dialysis Venture LLC

Doing business as Humboldt Ridge Dialysis Center

  • Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1043491194
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GARFIELD DIALYSIS VENTURE LLC
Doing business as
Humboldt Ridge Dialysis Center
Practice address
2211 N Humboldt Blvd
Milwaukee, WI 53212-3507
Phone
(414) 336-7200
Fax
(414) 777-5210
NPI assigned
Nov 16, 2007
Last updated
Dec 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Authorized official

Name
Mr. Barry Lee Luckenbill
Title
Managing Member
Phone
(414) 777-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

2211 N Humboldt Blvd
Milwaukee, WI 53212-3507

Mailing address

2514 S 102ND St
Suite 120
West Allis, WI 53227-2142
Phone (414) 777-5200

Other names 1

  • Humboldt Ridge Dialysis Center Doing business as

National Provider Directory

National Provider Directory

Locations

2211 N Humboldt Blvd
Milwaukee, WI 53212
Phone (414) 336-7200

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1043491194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 S 102ND ST",
            "address_2": "SUITE 120",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272142",
            "telephone_number": "414-777-5200",
            "fax_number": "414-777-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 N HUMBOLDT BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123507",
            "telephone_number": "414-336-7200",
            "fax_number": "414-777-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARFIELD DIALYSIS VENTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "LUCKENBILL",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "414-777-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humboldt Ridge Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.