Dialysis Clinic Inc.

Primary specialty

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

License

067 Issued in LA

Legal business name

DIALYSIS CLINIC INC.

Practice address

1010 Behrman Hwy
Gretna, LA 70056-4566

Phone

(504) 391-9572

Fax

(504) 391-0248

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Donovan Schultz

Title

President

Phone

(615) 327-3061

Specialties & licenses 1

Addresses

Other identifiers 2

Member of 1

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

• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brownsville, TN
  • NPI 1013940493

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1265465645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 BEHRMAN HWY",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700564566",
            "telephone_number": "504-391-9572",
            "fax_number": "504-391-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BEHRMAN HWY",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700564566",
            "telephone_number": "504-391-9572",
            "fax_number": "504-391-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "LA",
            "license": "067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09137000",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1995576",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deluxe Medical Corporation
• Ian Matthew Dermody, LPC
• Jean Desse, M.D
• Ashleigh M Dewell, AUD
• Dfac3 LLC
• Renee' Diaz, RN
• Arthur Weldon Dickerson, D.D.S.
• Stephanie Diggs
• Melissa Failla Dilosa, LPC-S, NCC
• Damon Joel Dimarco, DDS

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Gretna, LA
• Providers in Gretna, LA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.