Pure Life Renal of Louisville, LLC

Primary specialty

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

Legal business name

PURE LIFE RENAL OF LOUISVILLE, LLC

Practice address

3935 Taylorsville Rd
Louisville, KY 40220-1455

Phone

(954) 962-5733

NPI assigned

Feb 27, 2020

Organization subpart

No

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

Authorized official

Name

Jeff Fernandez

Title

Cfo

Phone

(954) 962-5733

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Listed as

Pure Life Renal of LouisvilleCCN 182645

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Oct 8, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

17

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Don Ryan Duff, MD

  • Nephrology Physician
  • Louisville, KY
  • NPI 1154325900

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1629602727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD STE 300N",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211242",
            "telephone_number": "302-303-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201455",
            "telephone_number": "954-962-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE LIFE RENAL OF LOUISVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "954-962-5733"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Purdy, LCSW
• Marty Purdy
• Ronda Purdy
• Pure Essience Counseling and Family Services, LLC
• Pure Integrity Solutions
• Anabel Puri
• Vinay Puri, M.D.
• Purposeful Play LLC
• Amanda Pursell
• Steven H Pursell, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.