NPIMap

Organization Active NPI

Bright Dialysis LLC

Doing business as Bright Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Pierce, FL
National Provider Identifier
1316179062
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
BRIGHT DIALYSIS LLC
Doing business as
Bright Dialysis
Practice address
2000 Hartman Rd
Fort Pierce, FL 34947-4412
Phone
(772) 467-1117
Fax
(772) 595-9340
NPI assigned
Aug 13, 2009
Last updated
Jan 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Authorized official

Name
Sue E Rottura
Title
Manager
Phone
(561) 613-8830

Specialties & licenses 1

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

Addresses

Primary practice location

2000 Hartman Rd
Fort Pierce, FL 34947-4412

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 320-4214

Other identifiers 1

IdentifierTypeStateIssuer
001826000MedicaidFL

Other names 1

  • Bright Dialysis Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1316179062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4214",
            "fax_number": "877-735-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HARTMAN RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474412",
            "telephone_number": "772-467-1117",
            "fax_number": "772-595-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-13",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "ROTTURA",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-613-8830"
    },
    "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": "001826000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.