NPIMap

Organization Active NPI

Liberty Dialysis - Duneland LLC

Doing business as Duneland Dialysis - Coffee Creek

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chesterton, IN
National Provider Identifier
1306060140
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
LIBERTY DIALYSIS - DUNELAND LLC
Doing business as
Duneland Dialysis - Coffee Creek
Practice address
551 Seymour Drive
Suite 101
Chesterton, IN 46304
Phone
(206) 236-3255
NPI assigned
Apr 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Gary Scher
Title
Executive Vice President
Phone
(260) 494-2363

Specialties & licenses 1

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

Addresses

Primary practice location

551 Seymour Drive
Suite 101
Chesterton, IN 46304

Mailing address

3820 E Mercer Way
Mercer Island, WA 98040-3806
Phone (206) 236-3255

Other names 1

  • Duneland Dialysis - Coffee Creek Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Duneland Dialysis - Coffee Creek4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1008 S Edgewood Dr
Knox, IN 46534
Phone (574) 772-2480

1007 Lincolnway
#1107
La Porte, IN 46350
Phone (219) 531-2675

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306060140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 E MERCER WAY",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403806",
            "telephone_number": "206-236-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 SEYMOUR DRIVE",
            "address_2": "SUITE 101",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "46304",
            "telephone_number": "206-236-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - DUNELAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "260-494-2363"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duneland Dialysis - Coffee Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterton, IN

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.