Dialysis Specialists of Coshocton, Inc.

Primary specialty

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

License

383 Issued in OH

Legal business name

DIALYSIS SPECIALISTS OF COSHOCTON, INC.

Practice address

235 Kenwood Dr
Coshocton, OH 43812-1997

Phone

(740) 622-6474

Fax

(740) 622-6476

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Subbarayudu Koppera, MD

Title

President/Owner

Phone

(740) 622-6474

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dialysis Specialists of Coshocton, Inc Other name

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1922038090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 KENWOOD DR",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121997",
            "telephone_number": "740-622-6474",
            "fax_number": "740-622-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 KENWOOD DR",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121997",
            "telephone_number": "740-622-6474",
            "fax_number": "740-622-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS SPECIALISTS OF COSHOCTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "KOPPERA",
        "authorized_official_first_name": "SUBBARAYUDU",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "740-622-6474",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OH",
            "license": "383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2075178",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dialysis Specialists of Coshocton, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ali Shea Davis
• Melissa Dean
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• Megan Faith Devol, MS, ATC
• Christa Dewitt
• Norma Jean Dickerson, LPN
• Tanner Dickerson, D.C.
• Taylor Dillon
• David Dosser, LCDC III
• Donna Dovenbarger, CDCA.186934

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Coshocton, OH
• Providers in Coshocton, 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 Oct 17, 2011; 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.