Organization Active NPI

Peritoneal Dialysis Concepts Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dayton, OH
National Provider Identifier
1861424707
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
PERITONEAL DIALYSIS CONCEPTS INC.
Practice address
1 Elizabeth PL. 627 Edwin C Moses Blvd
Suite 2B
Dayton, OH 45417-1445
Phone
(937) 275-7402
Fax
(937) 424-3581
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Authorized official

Name
Mr. David F Sheperd
Title
Vice President
Phone
(248) 642-5038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1 Elizabeth PL. 627 Edwin C Moses Blvd
Suite 2B
Dayton, OH 45417-1445

Mailing address

30100 Telegraph Rd
Suite 200
Bingham Farms, MI 48025-4516
Phone (248) 723-0224

Other identifiers 3

IdentifierTypeStateIssuer
000000002891OtherOHANTHEM
6800191OtherUNITED HEALTH CARE
0133439MedicaidOH

Other names 1

  • Home Dialysis of Dayton Other name

National Provider Directory

National Provider Directory

Locations

1 Elizabeth Pl
Ste 2B
Dayton, OH 45417
Phone (937) 294-6030

6580 N Main St
#F
Dayton, OH 45415
Phone (937) 275-7402

627 S Edwin C Moses Blvd
Ste 2B
Dayton, OH 45417
Phone (937) 275-7402

4700 Springboro Pike
#300
Moraine, OH 45439
Phone (937) 294-6030

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1861424707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30100 TELEGRAPH RD",
            "address_2": "SUITE 200",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254516",
            "telephone_number": "248-723-0224",
            "fax_number": "248-642-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL. 627 EDWIN C MOSES BLVD",
            "address_2": "SUITE 2B",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454171445",
            "telephone_number": "937-275-7402",
            "fax_number": "937-424-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERITONEAL DIALYSIS CONCEPTS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "SHEPERD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "248-642-5038",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000002891",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "6800191",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133439",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Dialysis of Dayton",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.