Central New Hampshire Kidney Center,LLC

Primary specialty

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

License

1641 Issued in NH

Legal business name

CENTRAL NEW HAMPSHIRE KIDNEY CENTER,LLC

Practice address

87 Spring Street
Laconia, NH 03246

Phone

(603) 528-3738

Fax

(603) 524-8796

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Noshi A Ishak, MDNPI 1205952488

Title

Ceo Medical Director

Phone

(603) 528-3738

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Listed as

Central New Hampshire Kidney CenterCCN 302503

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Feb 16, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

21

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

CLIA laboratory certificates

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.

• Noshi A Ishak, MD

  • Nephrology Physician
  • Laconia, NH
  • NPI 1205952488
  Authorized official Same address or phone

Affiliated clinicians 1

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

• Noshi A Ishak, MD

  • Nephrology Physician
  • Laconia, NH
  • NPI 1205952488

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1679698765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 SPRING STREET",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "03246",
            "telephone_number": "603-528-3738",
            "fax_number": "603-524-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SPRING STREET",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "03246",
            "telephone_number": "603-528-3738",
            "fax_number": "603-524-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL NEW HAMPSHIRE KIDNEY CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "ISHAK",
        "authorized_official_first_name": "NOSHI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "603-528-3738",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NH",
            "license": "1641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30007939",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy Casanova, MED, DBH
• Stacy Casella
• Debbie Cassavant, HS DIPLOMA
• Shannon Cassidy, BSW
• Central New Hampshire ER Associates (Lakes Region General Hospital)
• Central New Hampshire Nephrology Clinic, PLLC
• Gary L Chandler, LICSW
• Janet Chaney
• Lily Chanthasak
• Jeanne Marie Chapman

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Laconia, NH
• Providers in Laconia, NH by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.