Marbell Dialysis LLC

Primary specialty

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

Legal business name

MARBELL DIALYSIS LLC

Doing business as

Southfield Home Training

Practice address

24647 Greenfield Rd
Southfield, MI 48075-3058

Phone

(947) 941-5473

Fax

(947) 941-5492

NPI assigned

Sep 2, 2021

Last updated

Oct 15, 2021By the provider in NPPES

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

John D Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4506

Specialties & licenses 1

Addresses

Other names 1

• Southfield Home Training Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

DaVita Southfield Home TrainingCCN 232748

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Apr 6, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

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

CLIA laboratory certificates

Part of

Davita Inc

Member of 1

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

• Total Renal Care, Inc.

  dba Bountiful Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bountiful, UT
  • NPI 1184387516

  Member Of

  NPD member

Locations

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Fawaz Al-Ejel, MD

  • Nephrology Physician
  • Southfield, MI
  • NPI 1871567651

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1215605472",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24647 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753058",
            "telephone_number": "947-941-5473",
            "fax_number": "947-941-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARBELL DIALYSIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4506"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southfield Home Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southfield Home Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Map Dental PLLC
• Maplewood Supportive Living
• Maplewood Supportive Living, Inc
• Jaclyn Mapley
• Alicia A Marabanian, CRNA
• Marc D. Meissner , MD, CM, PLLC
• Marc S Arnkoff M D and Gregory L. Weigler D O P C
• Gary March, D.O.
• Marina Marchesotti
• Diana Marciniak, MA CCC-SLP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Southfield, MI
• Providers in Southfield, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.