Active NPI
CDC Home Care Youngstown LTD
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Youngstown, OH
National Provider Identifier
1760580237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- CDC HOME CARE YOUNGSTOWN LTD
- Practice address
- 807 Southwestern Run
Youngstown, OH 44514-3688 - Phone
- (866) 533-0059
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gayle A Nemecek
- Title
- Coo
- Phone
- (216) 658-0458
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
807 Southwestern Run
Youngstown, OH 44514-3688
Mailing address
18720 Chagrin Blvd
Shaker Heights, OH 44122-4855
Phone (216) 295-7003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2883269 | Medicaid | OH |
Other names 1
- CDC Home Care Youngstown
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071113000749 | OH | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 6608964390 | Practice locations: Youngstown, OH |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- CDC Home Care Youngstown
- Overall star rating
- Ownership
- Profit
- Certified
- Jul 22, 2008
- Medicare certification status
- Active
- Chain
- Centers for Dialysis Care
- Dialysis stations
- 2
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D1072971 | CDC Home Care Youngstown | Certificate of waiver | Aug 27, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Painesville, OH
- NPI 1770882599
Member Of
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740960000000",
"number": "1760580237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18720 CHAGRIN BLVD",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441224855",
"telephone_number": "216-295-7003",
"fax_number": "216-295-7014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 SOUTHWESTERN RUN",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445143688",
"telephone_number": "866-533-0059"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CDC HOME CARE YOUNGSTOWN LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-20",
"last_updated": "2025-03-03",
"certification_date": "2025-03-03",
"status": "A",
"authorized_official_last_name": "NEMECEK",
"authorized_official_first_name": "GAYLE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "216-658-0458"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2883269",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CDC Home Care Youngstown",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.