Dialysis Centers of Northwest Ohio, LTD.

Primary specialty

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

License

0634DC Issued in OH

Legal business name

DIALYSIS CENTERS OF NORTHWEST OHIO, LTD.

Doing business as

U.S. Renal Care Fremont Dialysis

Practice address

2400 Enterprise St
Fremont, OH 43420-8550

Phone

(419) 332-9104

Fax

(419) 332-9105

NPI assigned

Jan 27, 2006

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• U.S. Renal Care Fremont Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Dialysis Centers of Northwest Ohio, LTD.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Toledo, OH
  • NPI 1184695314

  4183708779

  Same PAC ID
• Dialysis Centers of Northwest Ohio, LTD.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Toledo, OH
  • NPI 1770554917

  4183708779

  Same PAC ID

Listed as

Usrc Fremont DialysisCCN 362631

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Feb 21, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

11

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Dialysis Centers of Northwest Ohio LTD3 organizations share this tax ID, including this one

Part of

US Renal Care Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Dialysis Centers of Northwest Ohio, LTD.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Toledo, OH
  • NPI 1184695314
  NPD tax ID
• Dialysis Centers of Northwest Ohio, LTD.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Toledo, OH
  • NPI 1770554917
  NPD tax ID

Locations

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Allen L Flickinger, MD

  • Nephrology Physician
  • Toledo, OH
  • NPI 1538137229

  Dialysis facility

  Care Compare affiliation Name & address match
• Vidhit Krishan Puri, D.O.

  • Nephrology Physician
  • Toledo, OH
  • NPI 1295153567

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1992776132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19119",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036601",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ENTERPRISE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434208550",
            "telephone_number": "419-332-9104",
            "fax_number": "419-332-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CENTERS OF NORTHWEST OHIO, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2006-01-27",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OH",
            "license": "0634DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2243414",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Fremont Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia Kay Deran
• Gregory J Derodes, O.D.
• Michael Desrosiers
• Kimberly Ann Dewalt
• Daniel George Dewood
• Gerardo Diaz, QMHS
• Alyssa Dickman, PTA
• Jonathan F. Diller, M.D.
• Marissa Kay Dingledine, CDCA
• Abigail Doster

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fremont, OH
• Providers in Fremont, 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 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.