Kentwood Home Dialysis

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

Last updated

Mar 17, 2015By 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

Dr. James Bernard Hall, M.D.NPI 1871518597

Title

Owner

Phone

(601) 320-3922

Specialties & licenses 1

Addresses

Locations

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.

• James Bernard Hall, M.D.

  • Internal Medicine Physician
  • Brookhaven, MS
  • NPI 1871518597
  Authorized official Same address or phone

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": []
}

• Hera Management LLC (Elocin House)
• Hera Management LLC (Elocin House)
• Holy Spirit Comfort and Healing Centers, Inc. (Southeast Regional Medical Center, Inc.)
• Kentwood Family Clinic LLC
• Kentwood Family Pharmacy LLC
• Kentwood Manor Nursing Home, L.L.C.
• Carmen Kinzy, LPC
• Lets Keep It Moving Transportation
• Louisiana Step Up Organization (LA Step Up)
• Julian Lowe

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kentwood, LA
• Providers in Kentwood, 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 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.