Renal Treatment Centers Southeast LP

Primary specialty

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

Legal business name

RENAL TREATMENT CENTERS SOUTHEAST LP

Doing business as

Amelia Island Dialysis

Practice address

1525 Lime St
Suite 120
Fernandina Beach, FL 32034-3015

Phone

(904) 491-1998

Fax

(904) 491-0006

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Chief Accounting Officer

Phone

(253) 733-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amelia Island Dialysis Doing business as

Locations

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1316983299",
    "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": "615-238-3027",
            "fax_number": "800-246-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 LIME ST",
            "address_2": "SUITE 120",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343015",
            "telephone_number": "904-491-1998",
            "fax_number": "904-491-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS SOUTHEAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4500"
    },
    "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": "890120100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amelia Island Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaela Michelle Raper, BCBA
• Bryan Keith Rawlinson, P.A.
• Samuel T Rawls, MD
• Kim Rayburn, PHARMD
• Emily Nicole Reed, APRN
• William Scott Reynolds II, PHARMD
• Kyle A Rezac, D.O.
• Robert Patrick Rice, D.C.
• Karen Richardson, PTA
• Kimberly Ann Richardson, PHARMD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.