Macomb Regional Dialysis Centers, L.L.C.

Primary specialty

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

Legal business name

MACOMB REGIONAL DIALYSIS CENTERS, L.L.C.

Doing business as

Macomb Regional Dialysis Center

Practice address

16151 Ninteen Mile Rd
Suite 200
Clinton Township, MI 48038-1158

Phone

(586) 263-8350

Fax

(586) 263-8358

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

David Frederick Shepherd

Title

Vice President / Managing Agent

Phone

(248) 642-5038

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Macomb Regional Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Member of 1

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

• Henry Ford Health System

  • Optometrist
  • Detroit, MI
  • NPI 1346324688

  Member Of

  NPD member

Locations

Practitioners 1

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

• Eva Saha, M.D.

  • Nephrology Physician
  • Clinton Township, MI
  • NPI 1023117025
  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1689870594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30100 TELEGRAPH ROAD",
            "address_2": "SUITE 200",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254516",
            "telephone_number": "248-642-5038",
            "fax_number": "248-642-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16151 NINTEEN MILE RD",
            "address_2": "SUITE 200",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381158",
            "telephone_number": "586-263-8350",
            "fax_number": "586-263-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACOMB REGIONAL DIALYSIS CENTERS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "VICE PRESIDENT / MANAGING AGENT",
        "authorized_official_telephone_number": "248-642-5038"
    },
    "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": "BLUE CROSS TRADITIONAL AND TRUST SUPPLEMENTAL",
            "identifier": "S09456",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS TRADITIONAL AND TRUST",
            "identifier": "D8792",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macomb Regional Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Macomb General and Vascular Surgery, P.L.C.
• Macomb Intermediate School District
• Macomb Medical Supply Inc
• Macomb Oakland Regional Center Inc. (Easter Seals-Michigan, Inc)
• Macomb Pharmacy and Wellness
• Macomb Therapy Group, PLLC
• Lea Nichole Maddox, D.O.
• Sarah Madsen, PA-C
• Alex Andrew Maes, DPT
• Magnet Personal Home Care Services Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.