NPIMap

Organization Active NPI

Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1992751556
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ISD RENAL INC
Doing business as
Central Fort Wayne Dialysis
Practice address
1940 Bluffton Rd
Fort Wayne, IN 46809-1307
Phone
(260) 478-2659
Fax
(260) 478-2553
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Mr. James K Hilger
Title
VP of Reimbursement
Phone
(253) 272-1916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1940 Bluffton Rd
Fort Wayne, IN 46809-1307

Mailing address

5200 Virginia Way
Licensure & Certification
Brentwood, TN 37027-7569
Phone (615) 341-6374

Other names 1

  • Central Fort Wayne Dialysis Doing business as

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1992751556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "LICENSURE & CERTIFICATION",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-341-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 BLUFFTON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468091307",
            "telephone_number": "260-478-2659",
            "fax_number": "260-478-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP OF REIMBURSEMENT",
        "authorized_official_telephone_number": "253-272-1916",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "Central Fort Wayne Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.