Dialysis Clinic Inc.

Primary specialty

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

License

008 Issued in LA

Legal business name

DIALYSIS CLINIC INC.

Practice address

102 Admore Avenue
Shreveport, LA 71105

Phone

(318) 861-5051

Fax

(318) 861-5054

NPI assigned

Jul 8, 2006

Last updated

Oct 4, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Tax ID family

Margaret Dillard MD238 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Dialysis Clinic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lafayette, LA
  • NPI 1194989293
  NPD tax ID
• Dialysis Clinic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Broussard, LA
  • NPI 1255997110
  NPD tax ID
• Dialysis Clinic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Iberia, LA
  • NPI 1619424926
  NPD tax ID
• Dialysis Clinic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Minden, LA
  • NPI 1730835620
  NPD tax ID
• Dialysis Clinic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jennings, LA
  • NPI 1740206317
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Orleans, LA
  • NPI 1316966559
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Shreveport, LA
  • NPI 1356374730
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Shreveport, LA
  • NPI 1679592810
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Opelousas, LA
  • NPI 1760401905
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Crowley, LA
  • NPI 1942225636
  NPD tax ID

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

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": "1295768687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ADMORE AVENUE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-861-5051",
            "fax_number": "318-861-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ADMORE AVENUE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-861-5051",
            "fax_number": "318-861-5054"
        }
    ],
    "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": "008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1120855",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HO4527918",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diabetes Assessment and Management Center of Shreveport LLC
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• Diagnostic Imaging Associates
• Dialysis Clinic Inc
• Dialysis Clinic Inc.
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• Diamond Solace Psychiatric Services
• Diamond Transport Services LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Shreveport, LA
• Providers in Shreveport, 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.