Active NPI
Isd Renal, Inc.
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Florissant, MO
National Provider Identifier
1376077123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- ISD RENAL, INC.
- Doing business as
- Cross Keys Dialysis
- Practice address
- 14001 New Halls Ferry Rd Ste 133
Florissant, MO 63033-2708 - Phone
- (314) 839-7416
- Fax
- (314) 839-7464
- NPI assigned
- Apr 19, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samuel Wey
- Title
- VP Licensure & Certification
- Phone
- (615) 341-6641
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
14001 New Halls Ferry Rd Ste 133
Florissant, MO 63033-2708
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 137607712 | Medicaid | MO |
Other names 1
- Cross Keys Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170607000271 | MO | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 6507053790 | Practice locations: Florissant, MO |
Other NPIs with the same Medicare PAC ID 24
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Cookeville, TN
- NPI 1003390469
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Greensboro, GA
- NPI 1073816914
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Philadelphia, PA
- NPI 1134640949
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Indianapolis, IN
- NPI 1174006662
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- North Providence, RI
- NPI 1174579619
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pennsauken, NJ
- NPI 1194230441
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Bridgeport, OH
- NPI 1205396744
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Philadelphia, PA
- NPI 1235795204
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Englewood, NJ
- NPI 1245891670
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Philadelphia, PA
- NPI 1295344307
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Upper Darby, PA
- NPI 1316540388
6507053790
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Dayton, OH
- NPI 1336682707
6507053790
National Provider Directory
National Provider Directory- Tax ID family
- Renal Care of Marion
Organizations with this tax ID in the same state 4
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rolla, MO
- NPI 1063923753
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Florissant, MO
- NPI 1407384274
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Kansas City, MO
- NPI 1770539108
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Harrisonville, MO
- NPI 1811943756
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pearsall, TX
- NPI 1194789859
Member Of
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pageland, SC
- NPI 1548222615
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492560000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712707200000",
"number": "1376077123",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14001 NEW HALLS FERRY RD STE 133",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630332708",
"telephone_number": "314-839-7416",
"fax_number": "314-839-7464"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ISD RENAL, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2017-04-19",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A",
"authorized_official_last_name": "WEY",
"authorized_official_first_name": "SAMUEL",
"authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
"authorized_official_telephone_number": "615-341-6641"
},
"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": "137607712",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Cross Keys Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Cross Keys Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.