Wallis Dialysis LLC

Primary specialty

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

Legal business name

WALLIS DIALYSIS LLC

Doing business as

Ravenna Dialysis

Practice address

600 Enterprise Parkway
Ravenna, OH 44266-0001

Phone

(615) 341-6793

Fax

(866) 409-3229

NPI assigned

Nov 17, 2015

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Chief Accounting Officer

Phone

(253) 733-4500

Specialties & licenses 1

Addresses

Other names 1

• Ravenna Dialysis Doing business as

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1902270721",
    "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": "615-341-6793",
            "fax_number": "866-409-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ENTERPRISE PARKWAY",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442660001",
            "telephone_number": "615-341-6793",
            "fax_number": "866-409-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLIS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4500"
    },
    "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": "Ravenna Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda K Walker, LSW
• Kimberly Kay Walker
• Theodore Laurence Walker, PRSS
• Kristian Harold Wall, M.D.
• Lolita Lashell Wallace, MED ASST HHA STNA
• Deborah Walsh
• James David Walter II, D.O.
• Beth Ann Wanosik
• Hannah Ward, PT, DPT
• Leslie Ann Wasity

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ravenna, OH
• Providers in Ravenna, OH by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.