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

U.S. Renal Care La Porte Dialysis

Practice address

103 W 18TH St
La Porte, IN 46350-6631

Phone

(219) 326-6362

Fax

(219) 326-6393

NPI assigned

Jul 11, 2006

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

• U.S. Renal Care La Porte Dialysis 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

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Knox, IN
  • NPI 1437184199

  2466465695

  Same PAC ID
• Liberty Dialysis - Duneland LLC

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

  2466465695

  Same PAC ID

Listed as

Usrc LaporteCCN 152599

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 10, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

13

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

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

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Knox, IN
  • NPI 1437184199
  NPD tax ID
• Liberty Dialysis - Duneland LLC

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

Member of 1

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

• Dialysis Newco LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Viera, FL
  • NPI 1982970554

  Member Of

  NPD member

Affiliated clinicians 1

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

• John Patrick Brady, M.D.

  • Nephrology Physician
  • Chesterton, IN
  • NPI 1356347546

  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": "1459209600000",
    "number": "1578598249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 CHURCH ST",
            "address_2": "SUITE 1900",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192301",
            "telephone_number": "615-777-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W 18TH ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463506631",
            "telephone_number": "219-326-6362",
            "fax_number": "219-326-6393"
        }
    ],
    "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": "2016-03-29",
        "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": "200834980B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care La Porte Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsey N Leech
• Theodore James Lefeber, DMD
• Susan Lenig, LMHCA
• Debra Jane Leroy, LCSW
• Chen Liang
• Lifecraft LLC
• Lincoln Pediatrics
• Linda Sirugo, MD, PC
• Kelcie Lindsey, RBT
• Ryan Lingle, DO

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in La Porte, IN
• Providers in La Porte, 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 Mar 29, 2016; 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.