Tel Huron Dialysis LLC

Primary specialty

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

Legal business name

TEL HURON DIALYSIS LLC

Doing business as

Orchard Square Dialysis

Practice address

1900 S Telegraph Rd
Ste 200
Bloomfield Hills, MI 48302-0238

Phone

(248) 451-0954

Fax

(248) 451-0681

NPI assigned

Aug 22, 2008

Last updated

Oct 31, 2023By 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

Samuel T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Orchard Square Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Davita Tel Huron Dialysis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tel-Huron Dialysis, LLC

  dba Orchard Square Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bloomfield Hills, MI
  • NPI 1154714947
  NPD tax ID

Member of 1

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

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1598912461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4514",
            "fax_number": "866-594-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S TELEGRAPH RD",
            "address_2": "STE 200",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020238",
            "telephone_number": "248-451-0954",
            "fax_number": "248-451-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEL HURON DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-22",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "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": "1598912461",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orchard Square Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orchard Square Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaime Lyn-Essian Taylor, D.O.
• Shannon Margaret Taylor, PA-C
• Arkadi Tcherniak
• Tiffanye Teagarden-Brown
• Team Rehabilitation Services, LLC
• Tel-Huron Dialysis, LLC (Orchard Square Dialysis)
• Telegraph Urgent Care PLLC
• Teleid, PLLC
• Teleradiology Specialists of Michigan, PLLC
• Emily Nicole Tersigni

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.