Prodigy Dialysis

Primary specialty

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

License

MD042825E Issued in PA

Legal business name

PRODIGY DIALYSIS

Practice address

211 Thompson St
Seward, PA 15954-2053

Phone

(814) 539-0798

Fax

(814) 536-4751

NPI assigned

Oct 30, 2012

Organization subpart

No

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

Authorized official

Name

Cory Yacynych

Title

Practice Manager

Phone

(814) 299-4676

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1851645840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 OSBORNE ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054146",
            "telephone_number": "814-539-0798",
            "fax_number": "814-536-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 THOMPSON ST",
            "city": "SEWARD",
            "state": "PA",
            "postal_code": "159542053",
            "telephone_number": "814-539-0798",
            "fax_number": "814-536-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "YACYNYCH",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "814-299-4676"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PA",
            "license": "MD042825E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernard Andrew Leech, D,O.
• Abigail Helen McGinnis
• Brittany Hall Miller, PHARMD
• Nolan Richard Palko, PHARM.D
• Penn Neuromuscular Diagnostics, LLC
• Paige Reese
• Roadway Pharmacy, Inc.
• Roadway Pharmacy,Inc.
• Jonathan M Shafer, DO
• Lu Ann M Shiley, CPHT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Seward, PA
• Providers in Seward, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.