Organization Active NPI

Kidney Care Centers of Coshocton Ohio LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Coshocton, OH
National Provider Identifier
1053679423
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
KIDNEY CARE CENTERS OF COSHOCTON OHIO LLC
Practice address
23649 Airport Rd
Coshocton, OH 43812-9262
Phone
(740) 291-8030
Fax
(740) 291-8034
NPI assigned
Apr 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Sara Anne Brady
Title
Chief Nursing Officer
Phone
(208) 371-7878

Specialties & licenses 1

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

Addresses

Primary practice location

23649 Airport Rd
Coshocton, OH 43812-9262

Mailing address

23649 Airport Rd
Coshocton, OH 43812-9262
Phone (740) 291-8030

Other identifiers 1

IdentifierTypeStateIssuer
0075408MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120707000010 OH Part A Provider - End-Stage Renal Disease Facility (ESRD) 2769647239 Practice locations: Coshocton, OH

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Kidney Care Centers of Coshocton, OhioCCN 362786
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Oct 17, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Chain
American Renal Associates
Dialysis stations
14

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2043546Kidney Care Centers of Coshocton23649 Airport Road, Coshocton, OH 43812Certificate of waiverJul 4, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Locations

23649 Airport Rd
Coshocton, OH 43812
Phone (740) 291-8030

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1053679423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23649 AIRPORT RD",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438129262",
            "telephone_number": "740-291-8030",
            "fax_number": "740-291-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23649 AIRPORT RD",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438129262",
            "telephone_number": "740-291-8030",
            "fax_number": "740-291-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE CENTERS OF COSHOCTON OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "208-371-7878"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075408",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coshocton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.