NPIMap

Organization Active NPI

Kentwood Home Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Kentwood, LA
National Provider Identifier
1306240684
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
202586 Issued in LA
Legal business name
KENTWOOD HOME DIALYSIS
Practice address
800 3Rd St
Kentwood, LA 70444-2746
Phone
(601) 833-4111
NPI assigned
Oct 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Authorized official

Name
Dr. James Bernard Hall, M.D.
Title
Owner
Phone
(601) 320-3922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 202586 LA Primary

Addresses

Primary practice location

800 3Rd St
Kentwood, LA 70444-2746

Mailing address

800 3Rd St
Kentwood, LA 70444-2746
Phone (601) 833-4111

National Provider Directory

National Provider Directory

Locations

800 3rd St
Kentwood, LA 70444
Phone (601) 833-4111

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1306240684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 3RD ST",
            "city": "KENTWOOD",
            "state": "LA",
            "postal_code": "704442746",
            "telephone_number": "601-833-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 3RD ST",
            "city": "KENTWOOD",
            "state": "LA",
            "postal_code": "704442746",
            "telephone_number": "601-833-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTWOOD HOME DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-320-3922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "LA",
            "license": "202586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.