NPIMap

Organization Active NPI

Clark County Dialysis Facility, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Springfield, OH
National Provider Identifier
1598711137
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
192 Issued in OH
Legal business name
CLARK COUNTY DIALYSIS FACILITY, INC.
Practice address
247 S Burnett Rd
Suite 110
Springfield, OH 45505-2639
Phone
(937) 328-8921
Fax
(937) 328-8784
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeffrey S Spiers, RN
Title
Administrator
Phone
(937) 328-8933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 192 OH Primary

Addresses

Primary practice location

247 S Burnett Rd
Suite 110
Springfield, OH 45505-2639

Mailing address

247 S Burnett Rd
Suite 110
Springfield, OH 45505-2639
Phone (937) 328-8921

Other identifiers 1

IdentifierTypeStateIssuer
0545066MedicaidOH

Other names 1

  • CCDF Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598711137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 S BURNETT RD",
            "address_2": "SUITE 110",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455052639",
            "telephone_number": "937-328-8921",
            "fax_number": "937-328-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 S BURNETT RD",
            "address_2": "SUITE 110",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455052639",
            "telephone_number": "937-328-8921",
            "fax_number": "937-328-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK COUNTY DIALYSIS FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPIERS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "937-328-8933",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OH",
            "license": "192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0545066",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCDF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.