Abita Square Dialysis, LLC

Primary specialty

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

License

APPLYING FOR Issued in LA

Legal business name

ABITA SQUARE DIALYSIS, LLC

Practice address

397 Highway 21
Suite 601
Madisonville, LA 70447-3407

Phone

(985) 845-9000

NPI assigned

Oct 7, 2009

Last updated

Oct 7, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John E Angelo, MDNPI 1538143599

Title

Administrator

Phone

(985) 845-9000

Specialties & licenses 1

Addresses

Locations

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.

• John Edward Angelo, MD

  • Nephrology Physician
  • Covington, LA
  • NPI 1538143599
  NPD (past) Authorized official

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254873600000",
    "number": "1710212873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 HIGHWAY 21",
            "address_2": "SUITE 601",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "704473407",
            "telephone_number": "985-845-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 HIGHWAY 21",
            "address_2": "SUITE 601",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "704473407",
            "telephone_number": "985-845-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABITA SQUARE DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-07",
        "last_updated": "2009-10-07",
        "status": "A",
        "authorized_official_last_name": "ANGELO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "985-845-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "LA",
            "license": "APPLYING FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Accetta, MD
• Truit Arthur Acosta, DDS
• Active Movement Rehabilitation and Wellness, LLC
• Kara Adams, RN
• Gary Michael Agena, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Madisonville, LA
• Providers in Madisonville, LA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; 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.