NPIMap

Organization Active NPI

Neptune Artificial Kidney Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Neptune, NJ
National Provider Identifier
1811926504
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
80131 Issued in NJ
Legal business name
NEPTUNE ARTIFICIAL KIDNEY CENTER LLC
Doing business as
Shore Dialysis
Practice address
300 W Sylvania Ave
Ste 1
Neptune, NJ 07753-6017
Phone
(732) 988-3684
Fax
(732) 988-2054
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
John D Winstel
Title
Chief Accounting Officer
Phone
(253) 733-4501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 80131 NJ Primary

Addresses

Primary practice location

300 W Sylvania Ave
Ste 1
Neptune, NJ 07753-6017

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 341-6410

Other identifiers 1

IdentifierTypeStateIssuer
6539505MedicaidNJ

Other names 1

  • Shore Dialysis Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

300 W Sylvania Ave
Ste 1
Neptune, NJ 07753
Phone (732) 988-3684

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1811926504",
    "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": "615-341-6410",
            "fax_number": "888-662-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W SYLVANIA AVE",
            "address_2": "STE 1",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077536017",
            "telephone_number": "732-988-3684",
            "fax_number": "732-988-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPTUNE ARTIFICIAL KIDNEY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "80131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6539505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shore Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shore Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neptune, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.