Purity Dialysis Centers, Inc

Primary specialty

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

Legal business name

PURITY DIALYSIS CENTERS, INC

Practice address

525 Handeyside LN
Fort Atkinson, WI 53538-1281

Phone

(920) 563-8665

Fax

(920) 563-8643

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Tina M Waldron

Title

Billing Supervisor

Phone

(262) 646-6426

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Fort Atkinson Dialysis Center Doing business as

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273708800000",
    "number": "1245316892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 SUN VALLEY DR STE 200",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182318",
            "telephone_number": "262-646-4162",
            "fax_number": "262-646-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HANDEYSIDE LN",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381281",
            "telephone_number": "920-563-8665",
            "fax_number": "920-563-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURITY DIALYSIS CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-05-13",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "262-646-6426",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FADC CLIA #",
            "identifier": "52D0988777",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522533",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Atkinson Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Prickette
• Tyler Joseph Prickette, PHARMD
• Prime Training, LLC
• Andrew Lien Punsel, MPT
• Margaret Punsel
• Courtney M Quast, LPC, SAC
• Peter H Rahn, PT
• Amie J Ramczyk, PT
• Destinee Ramirez, RDH
• Kyle Redo, LAT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.