Kershaw Dialysis LLC

Primary specialty

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

Legal business name

KERSHAW DIALYSIS LLC

Doing business as

Oakland Broadway Dialysis

Practice address

4242 Broadway
Oakland, CA 94611-5130

Phone

(510) 654-4645

Fax

(510) 547-1548

NPI assigned

Aug 22, 2017

Organization subpart

No

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

Addresses

Other names 1

• Oakland Broadway Dialysis Doing business as

Member of 1

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

• Total Renal Care Inc

  dba Edgewater Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1831615855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-341-6793",
            "fax_number": "877-790-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 BROADWAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115130",
            "telephone_number": "510-654-4645",
            "fax_number": "510-547-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAW DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakland Broadway Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leah Elizabeth Kern, RDN
• Michael P Kern, M.D.
• Kristen Kernodle-Brown, M.A.
• Emilee Kerr, ASW
• Nancy Kersey, MFT
• Alicen Beatrice Kershaw, CPNP-AC
• Clara Kerwin
• Samuel Kessel
• Maria C. Kessides, MD
• Paul Kessinger, M.S.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oakland, CA
• Providers in Oakland, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.