Commonwealth Dialysis Center, LLC

Primary specialty

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

Legal business name

COMMONWEALTH DIALYSIS CENTER, LLC

Practice address

4848 S 76TH St
Suite 100
Greenfield, WI 53220-4361

Phone

(414) 281-6806

Fax

(414) 281-7289

NPI assigned

Nov 13, 2006

Last updated

Aug 22, 2020By 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. Herbert S Lawson

Title

Cfo

Phone

(303) 785-7521

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Commonwealth Dialysis Center Home Hemollc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Commonwealth Dialysis Center Home Hemo,LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Boulder, CO
  • NPI 1154654317
  NPD tax ID

Locations

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295806776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CENTRAL AVE",
            "address_2": "SUITE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012838",
            "telephone_number": "303-785-7523",
            "fax_number": "303-444-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 S 76TH ST",
            "address_2": "SUITE 100",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204361",
            "telephone_number": "414-281-6806",
            "fax_number": "414-281-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH DIALYSIS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-785-7521",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42057900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "3911991136010",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clement Manor, Inc.
• Rosanne B Clement, DPM
• Mary E. Clementi, FNP-C
• Madison Elizabeth Coady, PT
• Joanne Marie Colombo Hughes, MA AUDIOLOGY
• Community Integration Coordinators
• Complete Mobile Health, LLC
• Jared Connolly
• Krissy Connor, DDS
• Consuelo a Yee MD SC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Greenfield, WI
• Providers in Greenfield, WI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wisconsin

• 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.