Liberty Dialysis - Wilmington LLC

Primary specialty

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

Legal business name

LIBERTY DIALYSIS - WILMINGTON LLC

Doing business as

U.S. Renal Care Wilmington Dialysis

Practice address

913 Delaware Ave
Wilmington, DE 19806-4701

Phone

(302) 429-0142

Fax

(302) 429-0149

NPI assigned

Sep 14, 2007

Last updated

Mar 31, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• U.S. Renal Care Wilmington Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Listed as

USRC WilmingtonCCN 082517

Overall star rating

3.0 of 5

Ownership

Non-profit

Certified

Oct 15, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

18

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

US Renal Care Inc

Member of 1

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

• Dialysis Newco LLC

  dba U.S. Renal Care Chula Vista Broadway Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chula Vista, CA
  • NPI 1275809840

  Member Of

  NPD member

Locations

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Manish Garg, M.D.

  • Nephrology Physician
  • Wilmington, DE
  • NPI 1821035650

  Dialysis facility

  Care Compare affiliation Name & address match
• Prerna Sharma, MD

  • Nephrology Physician
  • Newark, DE
  • NPI 1497250070

  Dialysis facility

  Care Compare affiliation Name & address match
• James Best Torain, MD

  • Nephrology Physician
  • Newark, DE
  • NPI 1720641673

  Dialysis facility

  Care Compare affiliation Name & address match
• Ranine Ghamrawi, M.D.

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1821473109

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1821284662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 CHURCH ST",
            "address_2": "SUITE 1900",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192301",
            "telephone_number": "615-777-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 DELAWARE AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064701",
            "telephone_number": "302-429-0142",
            "fax_number": "302-429-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - WILMINGTON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2007-09-14",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "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": "1821284662",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Wilmington Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Rebecca Lewis
• Rebecca Joan Lewis
• Wendy Lewis
• Ina Li, M.D.
• Yuanli Li
• Brianna Licciardi
• Lice Whisperer
• Nina Leslie Licht, LPCMH
• Ellen Lider
• Amber Liedlich, COTA/L

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wilmington, DE
• Providers in Wilmington, DE by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.

Verify at the official NPI Registry.