Nephrology Inc.

Primary specialty

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

Legal business name

NEPHROLOGY INC.

Practice address

2855 Miller Drive
Suite 209
Plymouth, IN 46563

Phone

(574) 273-6787

Fax

(574) 968-0882

NPI assigned

Feb 14, 2007

Last updated

Oct 3, 2007By 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. Keith Mentz, CEO

Title

Ceo

Phone

(574) 273-6787

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1437291366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 RED COACH DRIVE",
            "address_2": "SUITE D",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453519",
            "telephone_number": "574-273-6787",
            "fax_number": "574-968-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 MILLER DRIVE",
            "address_2": "SUITE 209",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "46563",
            "telephone_number": "574-273-6787",
            "fax_number": "574-968-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "MENTZ",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-273-6787",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimberly Lynn Noon, ATC L
• Laurie Norman, LMHC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Plymouth, IN
• Providers in Plymouth, 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 3, 2007; 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.