Prodigy Dialysis

Primary specialty

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

License

MD042825E Issued in PA

Legal business name

PRODIGY DIALYSIS

Practice address

1100 W High St
Ebensburg, PA 15931-1706

Phone

(814) 419-8107

Fax

(814) 419-8108

NPI assigned

Apr 23, 2009

Last updated

Feb 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George J Frem, MDNPI 1053315549

Title

Medical Director

Phone

(814) 539-0798

Specialties & licenses 1

Addresses

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.

• George J Frem, MD

  • Nephrology Physician
  • Johnstown, PA
  • NPI 1053315549
  Authorized official Same address or phone

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1184868051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 OSBORNE ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054146",
            "telephone_number": "814-539-0798",
            "fax_number": "814-536-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W HIGH ST",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311706",
            "telephone_number": "814-419-8107",
            "fax_number": "814-419-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "FREM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "814-539-0798",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PA",
            "license": "MD042825E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Powell, RN
• Elyse Powers, RN
• Premier Podiatry Group PC
• Premier Podiatry Group PC
• Primary Health Network
• Nedward Prostejovsky
• Erin Quick, RN
• Jodi M Rager, CRNP
• Miles E Ranck III, DMD
• Emma Ratchford

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ebensburg, PA
• Providers in Ebensburg, PA by specialty
• 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 Feb 5, 2013; 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.