Organization Active NPI

Unity Healthcare, LLC

  • Nephrology Physician
  • Lafayette, IN
National Provider Identifier
1194074153
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
UNITY HEALTHCARE, LLC
Practice address
114 Executive Dr
Suite a
Lafayette, IN 47905-4883
Phone
(765) 446-5185
Fax
(765) 446-5186
NPI assigned
Sep 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Authorized official

Name
Heather Dawson
Title
Director of Billing
Phone
(765) 446-5417

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X IN Primary

Addresses

Primary practice location

114 Executive Dr
Suite a
Lafayette, IN 47905-4883

Mailing address

PO Box 4699
Lafayette, IN 47903-4699
Phone (765) 449-2732

Other identifiers 1

IdentifierTypeStateIssuer
201106800AMedicaidIN

Other names 1

  • Lafayette Kidney Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203001083 IN Part B Supplier - Clinic/Group Practice 0244123362 Receives reassigned benefits from 69 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Lafayette, IN; West Lafayette, IN; La Fayette, IN; Flora, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2047856Unity Healthcare, LLC / Lafayette Kidney Care114 Executive Dr, Ste a, Lafayette, IN 47905Certificate of waiverOct 3, 2026

National Provider Directory

National Provider Directory

Locations

3806 Amelia Ave
Ste 2
Lafayette, IN 47905
Phone (765) 449-3900

412 N Monroe St
Williamsport, IN 47993
Phone (765) 762-2496

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1194074153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4699",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479034699",
            "telephone_number": "765-449-2732",
            "fax_number": "765-449-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 EXECUTIVE DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054883",
            "telephone_number": "765-446-5185",
            "fax_number": "765-446-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "765-446-5417"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201106800A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lafayette Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.