NPIMap

Organization Active NPI

Wheeling Renal Care LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wheeling, WV
National Provider Identifier
1295730703
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
WHEELING RENAL CARE LLC
Practice address
500 Medical Park
Ste 100
Wheeling, WV 26003-7600
Phone
(304) 242-7770
Fax
(304) 243-3216
NPI assigned
Jun 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Debra Lucki, R.N.
Title
Assistant Administrator
Phone
(304) 242-7770

Specialties & licenses 1

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

Addresses

Primary practice location

500 Medical Park
Ste 100
Wheeling, WV 26003-7600

Mailing address

500 Medical Park
Ste 100
Wheeling, WV 26003-7600
Phone (304) 242-7770

Other identifiers 2

IdentifierTypeStateIssuer
2028504MedicaidOH
00700489353MedicaidWV

Other names 1

  • Wheeling Dialysis Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295730703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MEDICAL PARK",
            "address_2": "STE 100",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260037600",
            "telephone_number": "304-242-7770",
            "fax_number": "304-243-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEDICAL PARK",
            "address_2": "STE 100",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260037600",
            "telephone_number": "304-242-7770",
            "fax_number": "304-243-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEELING RENAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUCKI",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "304-242-7770",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2028504",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00700489353",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wheeling Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.