Branson Dialysis, LLC

Primary specialty

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

Legal business name

BRANSON DIALYSIS, LLC

Practice address

101 Skaggs Rd Ste 301
Branson, MO 65616-2062

Phone

(417) 334-8288

Fax

(417) 334-6966

NPI assigned

Jan 31, 2007

Last updated

Nov 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie A Williams

Title

Administrator

Phone

(417) 334-8288

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Listed as

Branson DialysisCCN 262605

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Dec 20, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

11

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aleta B Greathouse, MD

  • Nephrology Physician
  • Joplin, MO
  • NPI 1427084136
  NPD (past)
• Phyllis Johnna Manna, PA-C

  • Medical Physician Assistant
  • Branson, MO
  • NPI 1528294667
  NPD (past)
• John Ray Martinez, M.D.

  • Nephrology Physician
  • Branson, MO
  • NPI 1154352417
  NPD (past)
• Habib G Munshi, M.D.

  • Pulmonary Disease Physician
  • Branson, MO
  • NPI 1033290101
  NPD (past)

Affiliated clinicians 3

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

• John Ray Martinez, M.D.

  • Nephrology Physician
  • Branson, MO
  • NPI 1154352417

  Dialysis facility

  Care Compare affiliation Name & address match
• Andi J Selby, DO

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1740444728

  Dialysis facility

  Care Compare affiliation Name & address match
• Dwight Patrick Zabel, M.D.

  • Nephrology Physician
  • Branson, MO
  • NPI 1245268051

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1588701239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SKAGGS RD STE 301",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162062",
            "telephone_number": "417-334-8288",
            "fax_number": "417-334-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SKAGGS RD STE 301",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162062",
            "telephone_number": "417-334-8288",
            "fax_number": "417-334-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANSON DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "417-334-8288"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "189725",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154508734",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502989320",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Branson, MO
• Providers in Branson, MO by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.