Phoenix Pediatric Dialysis Center LLC

Primary specialty

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

Legal business name

PHOENIX PEDIATRIC DIALYSIS CENTER LLC

Practice address

2545 E Thomas Rd
Suite 100
Phoenix, AZ 85016-7969

Phone

(602) 957-1648

Fax

(602) 957-2196

NPI assigned

Dec 12, 2016

Organization subpart

No

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

Authorized official

Name

Shari K Cousins

Title

Sr. VP of Clinical & Regulatory

Phone

(978) 922-3080

Specialties & licenses 1

Addresses

Other names 1

• Pediatric Dialysis Center of Phoenix Doing business as

Locations

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1841734720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E THOMAS RD",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167969",
            "telephone_number": "602-957-1648",
            "fax_number": "602-957-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 E THOMAS RD",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167969",
            "telephone_number": "602-957-1648",
            "fax_number": "602-957-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PEDIATRIC DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "COUSINS",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SR. VP OF CLINICAL & REGULATORY",
        "authorized_official_telephone_number": "978-922-3080"
    },
    "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": "Pediatric Dialysis Center of Phoenix",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Dialysis Center of Phoenix",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Phoenix Pediatrics LTD
• Phoenix Pet Partners, LLC
• Phoenix Physical Medicine LLC
• Phoenix Plastic Surgery, PLLC
• Phoenix Premiere Pain, LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.