Liberty Dialysis - Castle Rock LLC

Primary specialty

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

Legal business name

LIBERTY DIALYSIS - CASTLE ROCK LLC

Practice address

4352 Trail Boss Dr
Castle Rock, CO 80104-7512

Phone

(206) 236-5001

NPI assigned

Feb 13, 2008

Organization subpart

No

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

Authorized official

Name

Ryan B Pardo

Title

Vice President

Phone

(206) 816-6506

Specialties & licenses 1

Addresses

Member of 1

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

• National Medical Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bristol, TN
  • NPI 1477570117

  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.

• Monica Cobb, APRN

  • Acute Care Nurse Practitioner
  • Lakeland, FL
  • NPI 1407587587
  NPD (past)

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1255509170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 SE 27TH ST",
            "address_2": "SUITE 200",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403060",
            "telephone_number": "206-236-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4352 TRAIL BOSS DR",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801047512",
            "telephone_number": "206-236-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - CASTLE ROCK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "PARDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "206-816-6506"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Levine, CCC-SLP
• Evonne Mindy Levy, CAS
• Lindi Lewis, PHARMD
• Wendy S Lewis, RBT
• LHP, PC
• Nicole Cherie Lien, M.A CCC - SLP TSSLD
• Life Enrichment Opportunities, LLC
• Lifetouch Counseling PLLC
• Light & Lotus Wellness PLLC
• Diane Light, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.