Active NPI
Renal Life Link Inc
Doing business as Nelsonville Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Nelsonville, OH
National Provider Identifier
1063477982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- RENAL LIFE LINK INC
- Doing business as
- Nelsonville Dialysis
- Practice address
- 1950 Mount Saint Marys Dr
Nelsonville, OH 45764-1280 - Phone
- (740) 753-2398
- Fax
- (740) 753-2495
- NPI assigned
- Apr 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas O Usilton Jr.
- Title
- Group Vice President
- Phone
- (770) 541-7922
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
1950 Mount Saint Marys Dr
Nelsonville, OH 45764-1280
Mailing address
5200 Virginia Way
Ste. 400 L&C
Brentwood, TN 37027-7569
Phone (615) 320-4435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2639390 | Medicaid | OH |
Other names 1
- Nelsonville Dialysis
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Paulding Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Dallas, GA
- NPI 1073540506
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187222400000",
"number": "1063477982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "STE. 400 L&C",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277569",
"telephone_number": "615-320-4435",
"fax_number": "303-209-7821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 MOUNT SAINT MARYS DR",
"city": "NELSONVILLE",
"state": "OH",
"postal_code": "457641280",
"telephone_number": "740-753-2398",
"fax_number": "740-753-2495"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RENAL LIFE LINK INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-20",
"last_updated": "2007-08-16",
"status": "A",
"authorized_official_last_name": "USILTON",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "O",
"authorized_official_title_or_position": "GROUP VICE PRESIDENT",
"authorized_official_telephone_number": "770-541-7922",
"authorized_official_name_suffix": "Jr."
},
"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": "2639390",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Nelsonville Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Nelsonville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.