Haverhills Dialysis, LLC

Primary specialty

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

Legal business name

HAVERHILLS DIALYSIS, LLC

Practice address

2300 State Road 524 Ste 106
Cocoa, FL 32926-5894

Phone

(321) 482-5609

Fax

(321) 482-5868

NPI assigned

Jan 21, 2021

Organization subpart

Yes

Parent organization

DAVITA INCAs reported in NPPES

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

Authorized official

Name

John Winstel

Title

Chief Accounting Officer

Phone

(303) 405-5117

Specialties & licenses 1

Addresses

Other names 1

• Cocoa Beach Dialysis Doing business as

Part of

Davita Inc

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1497345763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4283",
            "fax_number": "800-320-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 STATE ROAD 524 STE 106",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329265894",
            "telephone_number": "321-482-5609",
            "fax_number": "321-482-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVERHILLS DIALYSIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "303-405-5117"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cocoa Beach Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryan Harper
• Stacie Lynnette Hart, LDO
• Katy Harvey
• Erica Denise Harvill
• Hannah Haskins
• Lisa Ann Hawn, M.A., CCC-SLP
• Amanda Heath
• Heavenly Home Health Aid Inc.
• Janet L Helfand, PH.D.
• Lauren Helvig, M.S.W.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Cocoa, FL
• Providers in Cocoa, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.