NPIMap

Organization Active NPI

Kidney Care Services of Dubois LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Du Bois, PA
National Provider Identifier
1689869679
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
KIDNEY CARE SERVICES OF DUBOIS LLC
Practice address
635 Maple Ave
Box D
Du Bois, PA 15801-2376
Phone
(814) 375-4321
Fax
(814) 375-6157
NPI assigned
Sep 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Authorized official

Name
Mrs. Linda J Spencer, R.N.
Title
Managing Employee
Phone
(814) 590-9618

Specialties & licenses 1

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

Addresses

Primary practice location

635 Maple Ave
Box D
Du Bois, PA 15801-2376

Mailing address

635 Maple Ave
Box D
Du Bois, PA 15801-2376

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the 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.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1689869679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MAPLE AVE",
            "address_2": "BOX D",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MAPLE AVE",
            "address_2": "BOX D",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012376",
            "telephone_number": "814-375-4321",
            "fax_number": "814-375-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE SERVICES OF DUBOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "814-590-9618",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.