Kollobe Dialysis LLC

Primary specialty

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

Legal business name

KOLLOBE DIALYSIS LLC

Doing business as

Harvard Park Dialysis

Practice address

4670 Richmond Rd Ste 250
Cleveland, OH 44128-6411

Phone

(216) 378-9706

NPI assigned

May 2, 2019

Organization subpart

No

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

Addresses

Other names 1

• Harvard Park Dialysis Doing business as

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1902461213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-238-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 RICHMOND RD STE 250",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441286411",
            "telephone_number": "216-378-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOLLOBE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-02",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harvard Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harvard Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenna Lyn Koller, PT, DPT
• Sree Hari Praveen Kolli, M.D.
• George D Kollias, RPH
• Swapna Kollikonda, M.D.
• Holly Kollman
• Leela Krishna Kolluru, MBBS
• Helen Kollus, MD, MA
• Natalie Kolman, APRN.CNP
• Megan Kolner
• Kathy Kolodziejski

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Cleveland, OH
• Providers in Cleveland, 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 Apr 2, 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.