Active NPI
University of Louisville Research Foundation, Inc
Doing business as Kidney Disease Program / Louisville Renal Dialysis Facility
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Louisville, KY
National Provider Identifier
1629075825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 182501
- Legal business name
- UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC
- Doing business as
- Kidney Disease Program / Louisville Renal Dialysis Facility
- Practice address
- 615 S Preston St
Louisville, KY 40202-1715 - Phone
- (502) 852-5757
- Fax
- (502) 852-4039
- NPI assigned
- Jul 1, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Eleanor D Lederer, M.D.
- Title
- Chief, Division of Nephrology
- Phone
- (502) 852-5757
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 182501 | KY | Primary |
Addresses
Primary practice location
615 S Preston St
Louisville, KY 40202-1715
Mailing address
615 S Preston St
Louisville, KY 40202-1715
Phone (502) 852-5757
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100003040A | Other | IN | INDIANA MEDICAID |
| 39090030 | Medicaid | KY | |
| 000003108H | Other | KY | HUMANA HEALTH CARE NUMBER |
| 004541476 | Other | KY | AETNA PROVIDER # |
| 50001023 | Medicaid | KY | |
| 5416V4981 | Other | KY | AHDS PROVIDER # |
| 000000112462 | Other | KY | BCBS 12 DIGIT PROVIDER # |
| 350 | Other | KY | BLUE CROSS NUMBER |
Other names 1
- Kidney Disease Program / Louisville Renal Dialysis Facility
National Provider Directory
National Provider Directory- Tax ID family
- Kidney Disease Program Louisville Renal Dialysis Facility
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba University of Louisville Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Louisville, KY
- NPI 1972865038
Locations
215 Central Ave
Ste 110
Louisville, KY 40208
Phone (502) 852-5205
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1317945600000",
"number": "1629075825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 S PRESTON ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021715",
"telephone_number": "502-852-5757",
"fax_number": "502-852-4039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S PRESTON ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021715",
"telephone_number": "502-852-5757",
"fax_number": "502-852-4039"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-01",
"last_updated": "2011-10-07",
"status": "A",
"authorized_official_last_name": "LEDERER",
"authorized_official_first_name": "ELEANOR",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CHIEF, DIVISION OF NEPHROLOGY",
"authorized_official_telephone_number": "502-852-5757",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": "KY",
"license": "182501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA MEDICAID",
"identifier": "100003040A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39090030",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA HEALTH CARE NUMBER",
"identifier": "000003108H",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER #",
"identifier": "004541476",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "50001023",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHDS PROVIDER #",
"identifier": "5416V4981",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS 12 DIGIT PROVIDER #",
"identifier": "000000112462",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS NUMBER",
"identifier": "350",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kidney Disease Program / Louisville Renal Dialysis Facility",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Louisville, KY
- University of Louisville Research Foundation Inc. (ULRF Colorectal Surgery)
- University of Louisville Research Foundation Inc. (ULRF Endocrinology)
- University of Louisville Research Foundation, Inc (ULRF Radiological Associates)
- University of Louisville Research Foundation, Inc (Renal Transplant Laboratory)
- University of Louisville Research Foundation, Inc (Special Procedures Laboratory)
- University of Louisville Research Foundation, Inc (Campus Health Services Office - Health Science Center)
- University of Louisville Research Foundation, Inc (Children and Youth Project)
- University of Louisville Research Foundation, Inc. (Children and Youth Project - Home Health)
- University of Louisville Research Foundation, Inc. (ULRF Medicine - Center for Primary Care)
- University of Louisville Research Foundation, Inc. (ULRF Psychiatric Foundation)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.