Physicians Choice Dialysis of Bethany, LLC

Primary specialty

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

Legal business name

PHYSICIANS CHOICE DIALYSIS OF BETHANY, LLC

Practice address

2202 N. Flamingo Avenue
Bethany, OK 73008

Phone

(610) 495-8900

NPI assigned

May 21, 2021

Organization subpart

No

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

Authorized official

Name

Kelly Smith

Title

Director

Phone

(302) 290-7408

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David E Fisher, MD

  • Family Medicine Physician
  • Bethany, OK
  • NPI 1396717765
  NPD (past)
• Tariq Asadullah Khan, M.D.

  • Nephrology Physician
  • Oklahoma City, OK
  • NPI 1396804662
  NPD (past)

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1255906343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 COMMERCE CT STE 104",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643483",
            "telephone_number": "302-290-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 N. FLAMINGO AVENUE",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "73008",
            "telephone_number": "610-495-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CHOICE DIALYSIS OF BETHANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "302-290-7408"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.phychoice.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "2202 N. Flamingo Avenue",
            "city": "Bethany",
            "state": "OK",
            "country_code": "US",
            "postal_code": "73008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul&Associates Inc. Counseling Services
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• Giuliana E Pebbles
• Riley Rachelle Pettijohn, MS, CCC-SLP
• Pharmcareok, Inc.
• Elizabeth Claire Pickens, RBT, LMSW
• Olivia Pierce
• Kathryn Elain Posada, MS CCC SLP
• Brian L. Predmore, D.C.
• McKenzie Kendall Price, MS, CF-SLP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bethany, OK
• Providers in Bethany, OK by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.