Advanced Dialysis Center

Primary specialty

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

License

E2642R Issued in MD

Legal business name

ADVANCED DIALYSIS CENTER

Practice address

9101 Liberty Rd
Randallstown, MD 21133-3521

Phone

(410) 496-0077

Fax

(410) 496-6677

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Minessia Zarita Pearson, MSN

Title

Cfo

Phone

(301) 943-7808

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295828051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 ANNAPOLIS RD",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063100",
            "telephone_number": "301-577-1007",
            "fax_number": "301-577-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 LIBERTY RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333521",
            "telephone_number": "410-496-0077",
            "fax_number": "410-496-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DIALYSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "MINESSIA",
        "authorized_official_middle_name": "ZARITA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-943-7808",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MD",
            "license": "E2642R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Randallstown, MD
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Maryland

• 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.