The Dialysis Center of North Philadelphia LLC

Primary specialty

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

Legal business name

THE DIALYSIS CENTER OF NORTH PHILADELPHIA LLC

Practice address

1300 W Lehigh Ave
Suite 106
Philadelphia, PA 19132-2760

Phone

(215) 223-1018

Fax

(215) 223-1019

NPI assigned

Feb 10, 2015

Organization subpart

No

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

Authorized official

Name

Shari K Cousins

Title

Sr. VP of Clinical & Regulatory

Phone

(978) 922-3080

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1083005227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W LEHIGH AVE",
            "address_2": "SUITE 106",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191322760",
            "telephone_number": "215-223-1018",
            "fax_number": "215-223-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W LEHIGH AVE",
            "address_2": "SUITE 106",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191322760",
            "telephone_number": "215-223-1018",
            "fax_number": "215-223-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DIALYSIS CENTER OF NORTH PHILADELPHIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "COUSINS",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SR. VP OF CLINICAL & REGULATORY",
        "authorized_official_telephone_number": "978-922-3080"
    },
    "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": "1030408260001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Childrens Hospital of Philadelphia Practice Association
• The City Psychotherapy New York, LCSW, PLLC
• The Dantzler House
• The Dental Pavilion Inc
• The Devereux Foundation
• The Dialysis Center of West Philadelphia LLC
• The Dialysis Unit of Center City Philadelphia LLC
• The Divine Workers Homecare LLC
• The Doctor Shop LLC
• The Doedega

• All providers in Philadelphia, PA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.