NPIMap

Organization Active NPI

Liberty at Home Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dallas, TX
National Provider Identifier
1821477415
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
LIBERTY AT HOME DIALYSIS, LLC
Practice address
5535 Red Bird Center Dr
Suite 150
Dallas, TX 75237-1921
Phone
(214) 331-1112
Fax
(214) 331-1115
NPI assigned
May 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Robert Santelli
Title
Member
Phone
(206) 236-5001

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 017487 TX
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X TX Primary

Addresses

Primary practice location

5535 Red Bird Center Dr
Suite 150
Dallas, TX 75237-1921

Mailing address

5535 Red Bird Center Dr
Suite 150
Dallas, TX 75237-1921
Phone (214) 331-1112

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1821477415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 RED BIRD CENTER DR",
            "address_2": "SUITE 150",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752371921",
            "telephone_number": "214-331-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 RED BIRD CENTER DR",
            "address_2": "SUITE 150",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752371921",
            "telephone_number": "214-331-1112",
            "fax_number": "214-331-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY AT HOME DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "SANTELLI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "206-236-5001"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "017487",
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.