Harriman Dialysis LLC

Primary specialty

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

License

E2714 Issued in MD

Legal business name

HARRIMAN DIALYSIS LLC

Doing business as

Friendly Farms Home Dialysis

Practice address

10905 Fort Washington Rd
Ste 307
Fort Washington, MD 20744-5843

Phone

(301) 292-0540

Fax

(301) 292-3493

NPI assigned

Oct 2, 2014

Last updated

Mar 3, 2021By 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

John Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Friendly Farms Home Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

DaVita Friendly Farms Home Dialysis (PD-HHD)CCN 212714

Ownership

Profit

Certified

Sep 21, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

4

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member
• Total Renal Care, Inc.

  dba Bountiful Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bountiful, UT
  • NPI 1184387516

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Ann Lange Bishop, MD

  • Nephrology Physician
  • Gaithersburg, MD
  • NPI 1609929801
  NPD (past)

Affiliated clinicians 1

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

• Eric Antwi-Donkor, MD

  • Nephrology Physician
  • Washington, DC
  • NPI 1629053848

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1396148540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4214",
            "fax_number": "866-944-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 FORT WASHINGTON RD",
            "address_2": "STE 307",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445843",
            "telephone_number": "301-292-0540",
            "fax_number": "301-292-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIMAN DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MD",
            "license": "E2714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E2714",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000989 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendly Farms Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Friendly Farms Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alganesh Hailemariam, HHA
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• Roger Hamilton
• Harborview Urgent Care
• Michelle Leslie Harlow, PA-C
• Harris Wellness Counseling Service LLC
• Carolyn Diane Harris-Hutchinson, LICSW
• Arnold Harris, LCSW-C
• Cynthia Annette Tomorrow Harris
• Valerie Harris

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Washington, MD
• Providers in Fort Washington, MD by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.