NPIMap

Organization Active NPI

Home Advantage Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Grand Rapids, MI
National Provider Identifier
1255840427
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
HOME ADVANTAGE DIALYSIS
Practice address
1621 44TH St SW Ste 300
Grand Rapids, MI 49509-4387
Phone
(512) 328-6774
Fax
(512) 328-0779
NPI assigned
Sep 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. John R Hedrick
Title
Member
Phone
(512) 328-6774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1621 44TH St SW Ste 300
Grand Rapids, MI 49509-4387

Mailing address

1621 44TH St SW Ste 300
Grand Rapids, MI 49509-4387
Phone (512) 328-6774

Other names 1

  • HOME ADVANTAGE DIALYSIS MICHIGAN Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1255840427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 44TH ST SW STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495094387",
            "telephone_number": "512-328-6774",
            "fax_number": "512-328-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 44TH ST SW STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495094387",
            "telephone_number": "512-328-6774",
            "fax_number": "512-328-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME ADVANTAGE DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "512-328-6774",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOME ADVANTAGE DIALYSIS MICHIGAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.