Dialysis Care Center of Palm Coast LLC

Primary specialty

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

Legal business name

DIALYSIS CARE CENTER OF PALM COAST LLC

Practice address

515 Palm Coast Pkwy SW
Units 2, 3, & 4
Palm Coast, FL 32137-5700

Phone

(386) 447-4477

Fax

(386) 447-4476

NPI assigned

Nov 21, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Shari Cousins

Title

Sr. VP of Clinical & Regulatory

Phone

(978) 922-3080

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1962683714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PALM COAST PARKWAY SW",
            "address_2": "UNITS 2, 3, 4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321375700",
            "telephone_number": "386-447-4477",
            "fax_number": "386-447-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PALM COAST PKWY SW",
            "address_2": "UNITS 2, 3, & 4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321375700",
            "telephone_number": "386-447-4477",
            "fax_number": "386-447-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CARE CENTER OF PALM COAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "COUSINS",
        "authorized_official_first_name": "SHARI",
        "authorized_official_title_or_position": "SR. VP OF CLINICAL & REGULATORY",
        "authorized_official_telephone_number": "978-922-3080",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emany Jenesis Desinor
• Devindale Inc
• Kimberly Devine, LCSW
• Kristina Lynn Devors, LCSW
• Nilesh Prakash Dialani, MD
• Renata Dias de Oliveira, DDS
• Emma L Diaz
• Lindsay Michele Dibella
• Megan Katherine Dickerson, DPT
• Amanda S Dietz, MS-CCC, SLP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.