Dialysis Services of Belpre, Inc

Primary specialty

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

Legal business name

DIALYSIS SERVICES OF BELPRE, INC

Practice address

809 Farson Ave
Suite 108
Belpre, OH 45714-1066

Phone

(740) 401-0880

Fax

(740) 401-0885

NPI assigned

Jan 11, 2007

Last updated

Apr 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Subbarayudu Koppera, M.D.

Title

Medical Director

Phone

(740) 401-0880

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1942350830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 FARSON AVE",
            "address_2": "SUITE 108",
            "city": "BELPRE",
            "state": "OH",
            "postal_code": "457141066",
            "telephone_number": "740-401-0880",
            "fax_number": "740-401-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 FARSON AVE",
            "address_2": "SUITE 108",
            "city": "BELPRE",
            "state": "OH",
            "postal_code": "457141066",
            "telephone_number": "740-401-0880",
            "fax_number": "740-401-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS SERVICES OF BELPRE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "KOPPERA",
        "authorized_official_first_name": "SUBBARAYUDU",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "740-401-0880",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0533051",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Belpre, OH
• Providers in Belpre, 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 30, 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.