Jedburg Dialysis LLC

Primary specialty

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

License

ERD-0183 Issued in SC

Legal business name

JEDBURG DIALYSIS LLC

Doing business as

Jedburg Dialysis

Practice address

2897 W 5TH North St
Summerville, SC 29483-9674

Phone

(843) 873-3955

Fax

(843) 873-0266

NPI assigned

Jan 23, 2008

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Cheif Accounting Officer

Phone

(253) 733-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jedburg Dialysis Doing business as

Member of 1

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

• Total Renal Care Inc

  dba Cascade Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1578740387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2897 W 5TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294839674",
            "telephone_number": "843-873-3955",
            "fax_number": "843-873-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEDBURG DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHEIF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4500"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "SC",
            "license": "ERD-0183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ERD183",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jedburg Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James F. Deavers, OD, PA
• James Fox MD, LLC
• Katherine James, LCSW
• Thomas M Janecek, DDS
• JDR Contracting LLC
• Jeffrey P. Kraichely, D.C., P.C. (Healthworks)
• Elaine M Jenkins
• Michael C Jenkins, OTR/L
• Tonya Tomika Jenkins, CERTIFIED HAIR LOSS
• Doris Jenkinslpc, LPC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Summerville, SC
• Providers in Summerville, SC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.