Purity Dialysis Centers Inc

Primary specialty

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

Legal business name

PURITY DIALYSIS CENTERS INC

Practice address

2301 Sun Valley Dr Ste 101
Delafield, WI 53018-2318

Phone

(262) 646-6426

Fax

(262) 646-2498

NPI assigned

Feb 4, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Tina M Waldron

Title

Billing Supervisor

Phone

(262) 646-6426

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Purity Home Training Program Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Drew

  • Psychiatric/Mental Health Nurse Practitioner
  • Waukesha, WI
  • NPI 1134530769
  NPD (past)

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1669650545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 SUN VALLEY DR STE 200",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182318",
            "telephone_number": "262-646-6426",
            "fax_number": "262-646-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 SUN VALLEY DR STE 101",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182318",
            "telephone_number": "262-646-6426",
            "fax_number": "262-646-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURITY DIALYSIS CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "262-646-6426",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID NUMBER",
            "identifier": "52D1091140",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669650545",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Purity Home Training Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maureen Ann Pohle, L.P.C.
• Christopher Potrykus, D.D.S.
• Prohealth Medical Group Inc
• Glenda Lynn Prom-Stanlick, LCSW
• Kimberly Pulvermacher, LCSW
• Rebloom Mental Health LLC
• Carly Reed, D.C.
• Tyler Stephen Reed, D.C.
• Christy L Regan, PHARMD
• Michelle Deguzman Rego, LMT

• All providers in Delafield, WI
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.