Organization Active NPI

Independent Dialysis Foundation

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Baltimore, MD
National Provider Identifier
1316914062
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
INDEPENDENT DIALYSIS FOUNDATION
Practice address
840 Hollins St
Baltimore, MD 21201-1024
Phone
(410) 468-0900
Fax
(410) 468-0911
NPI assigned
Mar 1, 2006
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
Mr. Zeke Ayele
Title
Director of Information Systems
Phone
(410) 468-0900

Specialties & licenses 1

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

Addresses

Primary practice location

840 Hollins St
Baltimore, MD 21201-1024

Mailing address

840 Hollins St
Baltimore, MD 21201-1024
Phone (410) 468-0900

Other identifiers 4

IdentifierTypeStateIssuer
215143OtherMDIDF-PARKVIEW CENTER
215143OtherMDIDF-CHESTNUT SQUARE
0005759000MedicaidWV
01689292MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Independent Dialysis Foundation Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316914062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 HOLLINS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011024",
            "telephone_number": "410-468-0900",
            "fax_number": "410-468-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HOLLINS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011024",
            "telephone_number": "410-468-0900",
            "fax_number": "410-468-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT DIALYSIS FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AYELE",
        "authorized_official_first_name": "ZEKE",
        "authorized_official_title_or_position": "DIRECTOR OF INFORMATION SYSTEMS",
        "authorized_official_telephone_number": "410-468-0900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDF-PARKVIEW CENTER",
            "identifier": "215143",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDF-CHESTNUT SQUARE",
            "identifier": "215143",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005759000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01689292",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

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.