Organization Active NPI

Belmont Court Dialysis Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bensalem, PA
National Provider Identifier
1629165972
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
BELMONT COURT DIALYSIS CENTER INC
Practice address
1 Woodhaven Mall Ste 100
Bensalem, PA 19020-5609
Phone
(215) 633-1231
Fax
(215) 633-1225
NPI assigned
Oct 6, 2006
Last updated
Sep 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Authorized official

Name
Mrs. Jennifer L Bamgbose
Title
Billing Supervisor
Phone
(610) 630-1515

Specialties & licenses 1

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

Addresses

Primary practice location

1 Woodhaven Mall Ste 100
Bensalem, PA 19020-5609

Mailing address

2500 Boulevard of the Generals
Torresdale Campus
Norristown, PA 19403-3692
Phone (610) 630-1515

Other identifiers 6

IdentifierTypeStateIssuer
1007285120007MedicaidPA
PPA06037OtherPASTATE RENAL
50745OtherPAAETNA US HEALTH CARE
08380OtherPAHEALTH/SENIOR PARTNERS
0000487000OtherPAINDEPENDENCE BLUE CROSS
1021750OtherPAKEYSTONE MERCY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1629165972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BOULEVARD OF THE GENERALS",
            "address_2": "TORRESDALE CAMPUS",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194033692",
            "telephone_number": "610-630-1515",
            "fax_number": "610-630-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WOODHAVEN MALL STE 100",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205609",
            "telephone_number": "215-633-1231",
            "fax_number": "215-633-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELMONT COURT DIALYSIS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "BAMGBOSE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "610-630-1515",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007285120007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE RENAL",
            "identifier": "PPA06037",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTH CARE",
            "identifier": "50745",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH/SENIOR PARTNERS",
            "identifier": "08380",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0000487000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1021750",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.