Organization Active NPI

Dayton Regional Dialysis South Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dayton, OH
National Provider Identifier
1184698433
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
0014DC Issued in OH
Legal business name
DAYTON REGIONAL DIALYSIS SOUTH INC
Practice address
7700 Washington Village Dr
Suite 100
Dayton, OH 45459
Phone
(937) 438-9595
Fax
(937) 438-0009
NPI assigned
Feb 14, 2006
Last updated
Oct 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Mr. Michael L Sobecki
Title
Ceo
Phone
(937) 438-0099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 0014DC OH Primary

Addresses

Primary practice location

7700 Washington Village Dr
Suite 100
Dayton, OH 45459

Mailing address

7700 Washington Village Dr
Suite 220
Dayton, OH 45459
Phone (937) 438-9595

Other identifiers 1

IdentifierTypeStateIssuer
0925539MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1184698433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 WASHINGTON VILLAGE DR",
            "address_2": "SUITE 220",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-438-9595",
            "fax_number": "937-438-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 WASHINGTON VILLAGE DR",
            "address_2": "SUITE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-438-9595",
            "fax_number": "937-438-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON REGIONAL DIALYSIS SOUTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "SOBECKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-438-0099",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OH",
            "license": "0014DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0925539",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.