Harris Dialysis LLC

Primary specialty

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

License

S4202 Issued in AL

Legal business name

HARRIS DIALYSIS LLC

Doing business as

Limestone County Dialysis

Practice address

16236 Lucas Ferry Rd
Athens, AL 35611-3931

Phone

(256) 233-3965

Fax

(256) 233-3184

NPI assigned

May 31, 2012

Last updated

Feb 12, 2024By 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

Samuel Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Limestone County Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Member of 1

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

• Renal Treatment Centers-Southeast, LP.

  dba Hot Springs Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hot Springs, AR
  • NPI 1881938207

  Member Of

  NPD member

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1225399835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4268",
            "fax_number": "877-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16236 LUCAS FERRY RD",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356113931",
            "telephone_number": "256-233-3965",
            "fax_number": "256-233-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AL",
            "license": "S4202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137273",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Limestone County Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Limestone County Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John C Hamilton, MS, LAT, ATC
• April Ruf Haney, C.R.N.P.
• Matthew D Hanserd, MD
• Deborah Sue Hargrove, CRNP
• Donna N Harrell
• Jeremiah Lance Harris, D.M.D
• Eric Jason Hatfield, D.O.
• Katie Elizabeth Hatfield, CRNP
• Health Care Authority of Athens and Limestone County (Athens Limestone Hopsital)
• Healthcare Authority of Athens and Limestone County (Pia)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Athens, AL
• Providers in Athens, AL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.