Waterford Dialysis LLC

Primary specialty

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

Legal business name

WATERFORD DIALYSIS LLC

Doing business as

Trilogy Dialysis - Waterford

Practice address

800 St. Joseph Drive
Dialysis Clinic
Kokomo, IN 46901-1983

Phone

(765) 236-1239

NPI assigned

Jul 25, 2022

Last updated

Jul 25, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

TRILOGY DIALYSIS LLCAs reported in NPPES

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

Authorized official

Name

Cristina Pietrowski

Title

SVP & Chief Legal Officer

Phone

(502) 412-5847

Specialties & licenses 1

Addresses

Other names 1

• Trilogy Dialysis - Waterford Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Listed as

Trilogy Dialysis - WaterfordCCN 152712

Ownership

Profit

Certified

May 24, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

6

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

CLIA laboratory certificates

Locations

Affiliated clinicians 1

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

• Alok Silodia, M.D.

  • Nephrology Physician
  • Indianapolis, IN
  • NPI 1023202470

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1497481360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221648",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402521648",
            "telephone_number": "502-412-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ST. JOSEPH DRIVE",
            "address_2": "DIALYSIS CLINIC",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469011983",
            "telephone_number": "765-236-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFORD DIALYSIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRILOGY DIALYSIS LLC",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "PIETROWSKI",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "SVP & CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "502-412-5847"
    },
    "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": "Trilogy Dialysis - Waterford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lance N Washington, MD
• Erin C. Washler, LCSW
• Elizabeth Waskom
• Gwenn Wasmuth
• Jan Wasmuth, RDN
• Hailey Watson
• Jessica Watson
• Robert Watson
• Jason C Watters, M.D.
• Pamela Watterson, LCSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kokomo, IN
• Providers in Kokomo, 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 Jul 25, 2022; 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.