Greater Charleston Dialysis, PLLC

Primary specialty

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

License

43517 Issued in WV

Legal business name

GREATER CHARLESTON DIALYSIS, PLLC

Practice address

24 Maccorkle Ave SW
South Charleston, WV 25303-1476

Phone

(304) 720-2222

Fax

(304) 720-2322

NPI assigned

Sep 14, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Julian L. Espiritu Jr., M.D.

Title

Director

Phone

(304) 720-2222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679568778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031476",
            "telephone_number": "304-720-2222",
            "fax_number": "304-720-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MACCORKLE AVE SW",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031476",
            "telephone_number": "304-720-2222",
            "fax_number": "304-720-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER CHARLESTON DIALYSIS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ESPIRITU",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "304-720-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "WV",
            "license": "43517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071269-001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aliyah Gray
• Gregory Gray
• Kara Gray, APRN; NP-C; FNP
• Kiara Shantale Gray
• Quisean Mikeal Gray
• Joseph Greathouse
• Kiara K Green
• Lisa Kay Green
• Stacy Green
• Steven Green

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Charleston, WV
• Providers in South Charleston, WV by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.