Organization Active NPI

Community Dialysis Centers, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Windsor Mill, MD
National Provider Identifier
1316989700
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
COMMUNITY DIALYSIS CENTERS, INC.
Practice address
2707 N Rolling Rd
Suite 104
Windsor Mill, MD 21244-2157
Phone
(410) 277-9101
Fax
(410) 277-9001
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Authorized official

Name
Shannon Green, RD CDE CSR LDN
Title
Operations Coordinator
Phone
(410) 277-9101

Specialties & licenses 1

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

Addresses

Primary practice location

2707 N Rolling Rd
Suite 104
Windsor Mill, MD 21244-2157

Mailing address

2707 N Rolling Rd
Suite 104
Windsor Mill, MD 21244-2157
Phone (410) 277-9101

Other identifiers 1

IdentifierTypeStateIssuer
404136400MedicaidMD

National Provider Directory

National Provider Directory

Locations

2707 N Rolling Rd
Ste 104
Windsor Mill, MD 21244
Phone (410) 277-9101

2707 N Rolling Rd
Ste 104105
Windsor Mill, MD 21244
Phone (410) 277-9101

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1316989700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 N ROLLING RD",
            "address_2": "SUITE 104",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442157",
            "telephone_number": "410-277-9101",
            "fax_number": "410-277-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 N ROLLING RD",
            "address_2": "SUITE 104",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442157",
            "telephone_number": "410-277-9101",
            "fax_number": "410-277-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DIALYSIS CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OPERATIONS COORDINATOR",
        "authorized_official_telephone_number": "410-277-9101",
        "authorized_official_credential": "RD CDE CSR LDN"
    },
    "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": "404136400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.