Nra Dickson Tennessee LLC

Primary specialty

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

License

0000000162 Issued in TN

Legal business name

NRA DICKSON TENNESSEE LLC

Doing business as

Dickson Dialysis Clinic

Practice address

254 Beasley Dr.
Dickson, TN 37055

Phone

(615) 771-4400

Fax

(615) 771-4401

NPI assigned

Oct 16, 2006

Last updated

Feb 15, 2011By 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

Mr. Jon M. Sundock

Title

Vice President

Phone

(615) 507-3307

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dickson Dialysis Clinic Doing business as

Member of 1

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

• National Medical Care, Inc.

  dba Renal Care Center (RCC) of Johnson City

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Johnson City, TN
  • NPI 1215049044

  Member Of

  NPD member

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1407936354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 W. MCEWEN DRIVE",
            "address_2": "SUITE 500",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671731",
            "telephone_number": "615-661-1100",
            "fax_number": "615-507-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 BEASLEY DR.",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "37055",
            "telephone_number": "615-771-4400",
            "fax_number": "615-771-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NRA DICKSON TENNESSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "SUNDOCK",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-507-3307",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TN",
            "license": "0000000162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERT OF WAIVER",
            "identifier": "44D1060788",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dickson Dialysis Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chad Nicholson, MD
• Nol, LLC (Premier Radiology)
• Audrey Anteris Norman
• Northland Hearing Center, Inc. (The Hearing Aid Center)
• Jeffrey Franklin Norton, PA
• Ashley E O'Brien, APRN
• Kade Edward O'Leary, DO
• Todd Oldham, PHARM.D.
• Robbie L. Oliphant, LPN
• Connie Elaine Oliver

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Dickson, TN
• Providers in Dickson, TN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.