Independent Dialysis Foundation, Inc

Primary specialty

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

License

E2582 Issued in MD

Legal business name

INDEPENDENT DIALYSIS FOUNDATION, INC

Practice address

611 S Charles St
Baltimore, MD 21230-3801

Phone

(410) 468-0900

Fax

(410) 468-0911

NPI assigned

Aug 4, 2006

Last updated

Jul 16, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

INDEPENDENT DIALYSIS FOUNDATION, INCAs reported in NPPES

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

Authorized official

Name

Zeke Ayele

Title

Director of Information Systems

Phone

(410) 468-0900

Specialties & licenses 1

Addresses

Other identifiers 8

Part of

Independent Dialysis Foundation Inc

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1487662243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 HOLLINS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011024",
            "telephone_number": "410-468-0900",
            "fax_number": "410-468-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212303801",
            "telephone_number": "410-468-0900",
            "fax_number": "410-468-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT DIALYSIS FOUNDATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPENDENT DIALYSIS FOUNDATION, INC",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "AYELE",
        "authorized_official_first_name": "ZEKE",
        "authorized_official_title_or_position": "DIRECTOR OF INFORMATION SYSTEMS",
        "authorized_official_telephone_number": "410-468-0900"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MD",
            "license": "E2582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "215143",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "576241-03",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEP",
            "identifier": "PS8",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0704865003",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01689292",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005759000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0125608",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAI MEDICAL",
            "identifier": "21506",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inclusive Care, Inc
• Independence & Company
• Independence Foundation, Inc.
• Independent Dialysis Foundation
• Independent Dialysis Foundation, Inc
• Independent Dialysis Foundation, Inc
• Independent Drug Immunization LLC (Marelaine Inc)
• Indigo Physiotherapy, LLC
• Indigo Roland Park LLC (Indigo Physiotherapy)
• Joan Lynn Indilisano, OTR/L

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Baltimore, MD
• Providers in Baltimore, 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 Jul 16, 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.