NPIMap

Organization Active NPI

Midwest Dialysis Center, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1083735567
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
MIDWEST DIALYSIS CENTER, INC
Practice address
3120 S 27TH St
Milwaukee, WI 53215-4338
Phone
(414) 672-1006
Fax
(414) 672-1016
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name
Mr. David A Kurz
Title
V.P. Operations
Phone
(414) 762-2020

Specialties & licenses 1

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

Addresses

Primary practice location

3120 S 27TH St
Milwaukee, WI 53215-4338

Mailing address

335 East Mahn Court
Oak Creek, WI 53154
Phone (414) 762-2020

Other identifiers 3

IdentifierTypeStateIssuer
42063100OtherWIMEDICAID PROVIDER NUMBER
42063100MedicaidWI
522573OtherWIMEDICARE PROVIDER NUMBER

Other names 1

  • Midwest Dialysis Center, Inc-27th Street Branch Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1083735567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 EAST MAHN COURT",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "53154",
            "telephone_number": "414-762-2020",
            "fax_number": "414-762-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 S 27TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154338",
            "telephone_number": "414-672-1006",
            "fax_number": "414-672-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DIALYSIS CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "KURZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "V.P. OPERATIONS",
        "authorized_official_telephone_number": "414-762-2020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "42063100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42063100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "522573",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Dialysis Center, Inc-27th Street Branch",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 27, 2011; 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.