Organization Active NPI

Heartland Kidney and Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Neosho, MO
National Provider Identifier
1407193063
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
HEARTLAND KIDNEY AND DIALYSIS CENTER
Practice address
833 N Bus 49
Neosho, MO 64850-6898
Phone
(417) 455-9255
Fax
(417) 455-9422
NPI assigned
Jan 15, 2013
Last updated
Jul 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Authorized official

Name
Leslie M Hamlett, D.O.NPI 1720012628
Title
President
Phone
(417) 455-9255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

833 N Bus 49
Neosho, MO 64850-6898

Mailing address

2828 S Grand Ave
Carthage, MO 64836-7905
Phone (417) 358-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130205000586 MO Part A Provider - End-Stage Renal Disease Facility (ESRD) 6800040528 Practice locations: Neosho, MO

National Provider Directory

National Provider Directory

Member of 1

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

Locations

833 N Business 49
Neosho, MO 64850
Phone (417) 455-9255

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1407193063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 S GRAND AVE",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648367905",
            "telephone_number": "417-358-5500",
            "fax_number": "417-358-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 N BUS 49",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648506898",
            "telephone_number": "417-455-9255",
            "fax_number": "417-455-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND KIDNEY AND DIALYSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-15",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "HAMLETT",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-455-9255",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neosho, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; 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.

Verify at the official NPI Registry.