La Grange Dialysis LLC

Primary specialty

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

Legal business name

LA GRANGE DIALYSIS LLC

Doing business as

Corydon Dialysis Center

Practice address

1937 Old Highway 135 NW
Corydon, IN 47112-2013

Phone

(812) 738-5200

Fax

(812) 738-4935

NPI assigned

Jun 24, 2008

Last updated

Sep 25, 2008By 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

Jim Hilger

Title

Vice President

Phone

(253) 382-1919

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Corydon Dialysis Center Doing business as

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1972764744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "STE 400 L&C",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4521",
            "fax_number": "866-594-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 OLD HIGHWAY 135 NW",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471122013",
            "telephone_number": "812-738-5200",
            "fax_number": "812-738-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA GRANGE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "253-382-1919"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200889000A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100049230",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corydon Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taryne Knott, LCSW
• Dawn M. Kopp, FNP-C
• Jennifer Catherine Krider, MT-BC
• Hannah Marie Kuerzi, DPT
• Rajashekar U Kumar, M.D.
• Megan N Landis, M.D.
• Frances M Lasley
• Sharon Taurman Laufer, MD
• Sandra Denise Lemmel, APRN
• Ted Charles Lewis, DMD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Corydon, IN
• Providers in Corydon, IN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.