Dialysis Clinic Inc.

Primary specialty

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

Legal business name

DIALYSIS CLINIC INC.

Practice address

3300 Lemone Blvd.
Columbia, MO 65201

Phone

(573) 443-1531

Fax

(573) 449-7653

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Donovan Schultz

Title

President

Phone

(615) 327-3061

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Listed as

Dialysis Clinics, Inc - ColumbiaCCN 262506

Overall star rating

1.0 of 5

Ownership

Non-profit

Certified

Jan 30, 1982

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Dialysis Clinic, Inc.

Dialysis stations

37

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

CLIA laboratory certificates

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Affiliated clinicians 5

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

• Madhukar Misra, M.D.

  • Nephrology Physician
  • Columbia, MO
  • NPI 1851342158

  Dialysis facility

  Care Compare affiliation Name & address match
• Jeffrey Mark Stein, M.D.

  • Pediatric Nephrology Physician
  • Columbia, MO
  • NPI 1952583809

  Dialysis facility

  Care Compare affiliation Name & address match
• Kurt Daniel Tarwater, M.D.

  • Nephrology Physician
  • Columbia, MO
  • NPI 1134230097

  Dialysis facility

  Care Compare affiliation Name & address match
• Myra June Watson, D.O.

  • Nephrology Physician
  • Columbia, MO
  • NPI 1366448425

  Dialysis facility

  Care Compare affiliation Name & address match
• William Kellar Winkelmeyer, M.D.

  • Nephrology Physician
  • Columbia, MO
  • NPI 1316943475

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1215952908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 LEMONE BLVD.",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65201",
            "telephone_number": "573-443-1531",
            "fax_number": "573-449-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 LEMONE BLVD.",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65201",
            "telephone_number": "573-443-1531",
            "fax_number": "573-449-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501565105",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620580498010",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendall Margaret Dewein, LCSW
• Jenny Veronica Gorost Deyto, PA-C
• Shuvangee Dhar
• Ginger Beth Dial, N.A.S.M.
• Dialysis Clinic Inc
• Alberto A Diaz-Arias, MD
• Michele Diaz-Arias, MD
• Michael Dibenedetto
• William Kennent Dickinson, R.PH.
• Erica Rochelle Dickson

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Columbia, MO
• Providers in Columbia, MO by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.