Southeastern Michigan Kidney Center PLLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

SOUTHEASTERN MICHIGAN KIDNEY CENTER PLLC

Practice address

1695 W 12 Mile Rd
Suite 250
Berkley, MI 48072-2183

Phone

(248) 414-5200

Fax

(248) 414-5227

NPI assigned

Jul 20, 2006

Last updated

Sep 28, 2011By 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

Mr. David F Shepherd

Title

Vice President

Phone

(248) 642-5038

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

Southeast Michigan Kidney CenterCCN 232574

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Jun 2, 1999

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Greenfield Health Systems

Dialysis stations

2

Locations

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Lawrence A Greenberg, D.O.

  • Nephrology Physician
  • Troy, MI
  • NPI 1568459196

  Dialysis facility

  Care Compare affiliation Name & address match
• Olaf C Kroneman III, MD

  • Nephrology Physician
  • Berkley, MI
  • NPI 1316938061

  Dialysis facility

  Care Compare affiliation Name & address match
• Abhishek Swami

  • Internal Medicine Physician
  • Berkley, MI
  • NPI 1164637849

  Dialysis facility

  Care Compare affiliation Name & address match
• Khalid Zafar, MD

  • Nephrology Physician
  • Berkley, MI
  • NPI 1750363453

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1316967797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30100 TELEGRAPH RD",
            "address_2": "SUITE 200",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254516",
            "telephone_number": "248-723-0224",
            "fax_number": "248-642-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 W 12 MILE RD",
            "address_2": "SUITE 250",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722183",
            "telephone_number": "248-414-5200",
            "fax_number": "248-414-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN MICHIGAN KIDNEY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "248-642-5038",
        "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": [],
    "endpoints": [],
    "other_names": []
}

• Smile Clinic of Berkley
• Alexandra Gerra Smith, LLMSW
• Haley Smith, PA-C
• Richard M Smith, BS
• Jamie Soli, RDH
• Southern Home Care Services, Inc. (All Ways Caring HomeCare)
• Spbas LLC
• John Peyton Speck, M.D.
• Michelle Spencer, RDH
• Jennifer Lynn Sperber-Garrison

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Berkley, MI
• Providers in Berkley, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.