Lasalle Dialysis LLC

Primary specialty

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

Legal business name

LASALLE DIALYSIS LLC

Practice address

1001 E 2ND St
Coudersport, PA 16915-8161

Phone

(814) 655-3779

Fax

(814) 655-3791

NPI assigned

Feb 21, 2022

Organization subpart

Yes

Parent organization

DAVITA INCAs reported in NPPES

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

Authorized official

Name

Samuel Wey

Title

VP L&C Dept

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other names 1

• Coudersport Home Training Doing business as

Part of

Davita Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Practitioners 1

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

• Filitsa Bender

  • Nephrology Physician
  • Pittsburgh, PA
  • NPI 1851458418
  NPD (past)

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1194470872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-655-3779",
            "fax_number": "814-655-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASALLE DIALYSIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2022-02-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP L&C DEPT",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coudersport Home Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coudersport Home Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ekta Khanna, M.D.
• Craig Kinney, PTA
• Dennis Albert Larkin Jr., PTA
• Michael Richard Larsen, DC
• Haleigh Nicole Larson, BSDH, RDH, PHDHP
• Barbara Lawler
• Lawrence Clifton Wei, MD
• Drew Fee Levavasseur, PHARMD
• Emily A Lynch, PA-C
• M.E. Nurbhai, M.D,, P.C.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Coudersport, PA
• Providers in Coudersport, 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 Mar 21, 2024; 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.