Liberty Dialysis - Duneland LLC

Primary specialty

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

Legal business name

LIBERTY DIALYSIS - DUNELAND LLC

Doing business as

Duneland Dialysis Knox

Practice address

1008 Edgewood Drive
Knox, IN 46534

Phone

(574) 772-2480

Fax

(574) 772-4942

NPI assigned

Jul 11, 2006

Last updated

Oct 19, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Duneland Dialysis Knox Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Liberty Dialysis - Duneland LLC

  dba U.S. Renal Care Coffee Creek Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chesterton, IN
  • NPI 1457383069

  2466465695

  Same PAC ID
• Liberty Dialysis - Duneland LLC

  dba U.S. Renal Care La Porte Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • La Porte, IN
  • NPI 1578598249

  2466465695

  Same PAC ID

Listed as

Usrc Knox DialysisCCN 152608

Ownership

Profit

Certified

Apr 9, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

9

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

CLIA laboratory certificates

Tax ID family

Duneland Dialysis - Coffee Creek4 organizations share this tax ID, including this one

Part of

US Renal Care Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Liberty Dialysis - Duneland LLC

  dba Duneland Dialysis - Coffee Creek

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chesterton, IN
  • NPI 1306060140
  NPD tax ID
• Liberty Dialysis - Duneland LLC

  dba U.S. Renal Care Coffee Creek Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chesterton, IN
  • NPI 1457383069
  NPD tax ID
• Liberty Dialysis - Duneland LLC

  dba U.S. Renal Care La Porte Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • La Porte, IN
  • NPI 1578598249
  NPD tax ID

Member of 1

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

• Dialysis Newco LLC

  dba U.S. Renal Care Chula Vista Broadway Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chula Vista, CA
  • NPI 1275809840

  Member Of

  NPD member

Affiliated clinicians 1

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

• Sumedha Dhar, M.D

  • Internal Medicine Physician
  • Chesterton, IN
  • NPI 1811204266

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508371200000",
    "number": "1437184199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638665",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638665",
            "telephone_number": "615-777-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 EDGEWOOD DRIVE",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "46534",
            "telephone_number": "574-772-2480",
            "fax_number": "574-772-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - DUNELAND LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-10-19",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "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": "200853190A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duneland Dialysis Knox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• La Porte Clinic Company LLC (Knox Family Medical Center)
• La Porte Regional Physician Network (LP Ortho at Knox)
• Laporte Regional Physician Network (Knox Family Medical Center)
• Laporte Regional Physician Network, Inc.
• Joseph Anthony Lark
• Roberto Antonio Luna, NP
• Stephanie Nichole Mareska, COTA
• MBS Fitness (MBS Fitness LLC)
• Med Ease Inc
• Med Ride Transport Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Knox, IN
• Providers in Knox, IN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.