NPIMap

Organization Active NPI

Davita Nephrology Medical Associates of Washington

  • Nephrology Physician
  • Franklin, IN
National Provider Identifier
1710098090
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF WASHINGTON
Practice address
1140 W Jefferson St
B
Franklin, IN 46131-2101
Phone
(317) 736-4337
Fax
(317) 736-6508
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Anthony Gabriel, MD
Title
President
Phone
(303) 626-6239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1140 W Jefferson St
B
Franklin, IN 46131-2101

Mailing address

1627 Cole Blvd
Bldg18
Lakewood, CO 80401-3315
Phone (303) 626-6239

Other identifiers 1

IdentifierTypeStateIssuer
200865690AMedicaidIN

Other names 1

  • Kidney Care of Central Indiana Doing business as

National Provider Directory

National Provider Directory

Locations

Box 60000
San Francisco, CA 94160

1140 W Jefferson St
Franklin, IN 46131
Phone (317) 736-4337

Practitioners & affiliated clinicians

Practitioners 2

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1710098090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 COLE BLVD",
            "address_2": "BLDG18",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013315",
            "telephone_number": "303-626-6239",
            "fax_number": "866-917-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W JEFFERSON ST",
            "address_2": "B",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461312101",
            "telephone_number": "317-736-4337",
            "fax_number": "317-736-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-626-6239",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200865690A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kidney Care of Central Indiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.