Renal Treatment Centers Southeast LP

Primary specialty

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

License

S0205 Issued in AL

Legal business name

RENAL TREATMENT CENTERS SOUTHEAST LP

Doing business as

Home Dialysis Options of Baldwin County

Practice address

27880 N Main St
Ste a
Daphne, AL 36526-7080

Phone

(251) 626-1086

Fax

(251) 626-4056

NPI assigned

Sep 27, 2007

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Chief Accounting Officer

Phone

(253) 733-4500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Home Dialysis Options of Baldwin County Doing business as

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1699962282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4268",
            "fax_number": "877-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27880 N MAIN ST",
            "address_2": "STE A",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267080",
            "telephone_number": "251-626-1086",
            "fax_number": "251-626-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS SOUTHEAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4500"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AL",
            "license": "S0205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107341",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "S0205",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Dialysis Options of Baldwin County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Home Dialysis Options of Baldwin County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melinda Rader, LPC
• Jonathan Clay Rainer, MD
• Larisa Ravitskiy, MD
• Joy Thomas Rayburn, MS, RDN, LDN
• Refine PT and Performance LLC
• Lori Ann Renner, LICSW
• Restorative Prosthetics & Orthotics LLC
• Brandy Lynn Rhodes, CRNP
• Lauren Layne Richardson, PA
• Alan Shawn Ridenoure, M.ED., ATC/L, CSCS

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Daphne, AL
• Providers in Daphne, AL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.