Renal Treatment Centers Southeast LP

Primary specialty

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

Legal business name

RENAL TREATMENT CENTERS SOUTHEAST LP

Doing business as

North Okaloosa Dialysis

Practice address

320 Redstone Ave W
Crestview, FL 32536-6433

Phone

(850) 683-5700

Fax

(850) 683-5704

NPI assigned

Mar 9, 2006

Organization subpart

No

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

Authorized official

Name

John D Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Okaloosa Dialysis Doing business as

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1629046362",
    "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": "615-320-4593",
            "fax_number": "800-293-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 REDSTONE AVE W",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366433",
            "telephone_number": "850-683-5700",
            "fax_number": "850-683-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS SOUTHEAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "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": "891199100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Okaloosa Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Okaloosa Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reeves Manor LLC
• Allison Rego
• Rehab Technologies LLC
• Heather Reiman, COTA/L
• Renal Care Group of the Southeast, Inc.
• Respiratory Services of Northwest Florida, Inc.
• Respiratory Services of Northwest Florida, Inc.
• Relita Reyes
• Gena Denise Rhodes, M.S., CCC-SLP
• Michele R Richard

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Crestview, FL
• Providers in Crestview, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.