NPIMap

Organization Active NPI

Davita of New York Inc

Doing business as Ithaca Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ithaca, NY
National Provider Identifier
1760647150
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DAVITA OF NEW YORK INC
Doing business as
Ithaca Dialysis Center
Practice address
201 Dates Dr
Ste 206
Ithaca, NY 14850-1345
Phone
(607) 272-1693
Fax
(607) 273-5580
NPI assigned
Jul 24, 2008
Last updated
Jul 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Authorized official

Name
Jim Hilger
Title
Vice President
Phone
(253) 382-1919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

201 Dates Dr
Ste 206
Ithaca, NY 14850-1345

Mailing address

5200 Virginia Way
Ste 400 L&C
Brentwood, TN 37027-7569
Phone (615) 320-4521

Other names 1

  • Ithaca Dialysis Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davita of New York Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1760647150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "STE 400 L&C",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4521",
            "fax_number": "866-594-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DATES DR",
            "address_2": "STE 206",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501345",
            "telephone_number": "607-272-1693",
            "fax_number": "607-273-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA OF NEW YORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-24",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "253-382-1919"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ithaca Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.