NPIMap

Organization Active NPI

Magoffin Dialysis LLC

Doing business as Dialysis at Deborah

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Browns Mills, NJ
National Provider Identifier
1841618907
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
MAGOFFIN DIALYSIS LLC
Doing business as
Dialysis at Deborah
Practice address
107 Trenton Rd
Browns Mills, NJ 08015-3202
Phone
(609) 893-3950
Fax
(609) 893-3704
NPI assigned
Apr 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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 Primary

Addresses

Primary practice location

107 Trenton Rd
Browns Mills, NJ 08015-3202

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0462331MedicaidNJ

Other names 1

  • Dialysis at Deborah Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140612001287 NJ Part A Provider - End-Stage Renal Disease Facility (ESRD) 1658504790 Practice locations: Browns Mills, NJ

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Dialysis at DeborahCCN 312648
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Apr 30, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
16

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2081695Dialysis at Deborah107 Trenton Road, Browns Mills, NJ 08015Certificate of waiverJul 28, 2028

National Provider Directory

National Provider Directory

Member of 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1841618907",
    "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": "107 TRENTON RD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "080153202",
            "telephone_number": "609-893-3950",
            "fax_number": "609-893-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGOFFIN DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-04",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462331",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dialysis at Deborah",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dialysis at Deborah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Browns Mills, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.