Belmont Court Dialysis Center Inc

Primary specialty

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

Legal business name

BELMONT COURT DIALYSIS CENTER INC

Practice address

2200 Michener St Ste 20-21
Philadelphia, PA 19115-4374

Phone

(215) 676-8800

Fax

(215) 676-4950

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer L Bamgbose

Title

Billing Supervisor

Phone

61063015151

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1821185166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BOULEVARD OF THE GENERALS",
            "address_2": "NORTHEAST CAMPUS",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194033692",
            "telephone_number": "610-630-1515",
            "fax_number": "610-630-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MICHENER ST STE 20-21",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154374",
            "telephone_number": "215-676-8800",
            "fax_number": "215-676-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELMONT COURT DIALYSIS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "BAMGBOSE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "61063015151",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "50745",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007285120001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1021750",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0000357000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH/SENIOR PARTNERS",
            "identifier": "08380",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE RENAL",
            "identifier": "PPA06037",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "X000260701",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Belmont Behavioral Hospital, LLC
• Belmont Behavioral Hospital, LLC
• Belmont Charter School
• Belmont Charter School
• Belmont Court Dialysis Center Inc
• Joseph Tyler Belmont, MS
• Chederli Gayle B Belongilot, MD
• Johane Belony
• Lauren Elise Belous, D.M.D.
• Beloved Home Care Agency LLC

• All providers in Philadelphia, PA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.