NPIMap

Organization Active NPI

Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Omaha, NE
National Provider Identifier
1609809086
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
ESRD007 Issued in NE
Legal business name
DIALYSIS CLINIC INC.
Practice address
3015 N 118TH Cir
Omaha, NE 68164-3685
Phone
(402) 493-9331
Fax
(402) 493-7677
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Mr. Donovan Schultz
Title
President
Phone
(615) 327-3061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X ESRD007 NE Primary

Addresses

Primary practice location

3015 N 118TH Cir
Omaha, NE 68164-3685

Mailing address

3015 N 118TH Cir
Omaha, NE 68164-3685
Phone (402) 493-9331

Other identifiers 1

IdentifierTypeStateIssuer
0907246MedicaidIA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1609809086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N 118TH CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643685",
            "telephone_number": "402-493-9331",
            "fax_number": "402-493-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N 118TH CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643685",
            "telephone_number": "402-493-9331",
            "fax_number": "402-493-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NE",
            "license": "ESRD007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0907246",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.