GREAT DIALYSIS LLC , NPI 1932413010 — MCKINNEY DIALYSIS in MCKINNEY (TX)

NPI 1932413010

10+ Years Experience Organization

GREAT DIALYSIS LLC

Other organization name: MCKINNEY DIALYSIS. Name type code: 3 - doing business as (d/b/ a) name.

08.02.2010
PROVIDER ENUMERATION DATE
10/29/2018
LAST UPDATE DATE
1932413010
NPI NUMBER

About GREAT DIALYSIS LLC

GREAT DIALYSIS LLC is a provider established in MCKINNEY, TX. The NPI number of GREAT DIALYSIS LLC is 1932413010 and was assigned on 08.02.2010. The practitioners primary taxonomy code is: 261QE0700X with license number: 110064 TX .

Mailing address

  • City: BRENTWOOD
  • State: TN
  • Postal code: 370277569
  • Phone: 6153416764
  • Fax: 8337816999
  • Address: 5200 VIRGINIA WAY
  • Address 2: L & C DEPT

Primary Practice Address

  • Region : MCKINNEY, TX
  • NPI : 1932413010
  • Phone : 9725420495
  • Fax : 9725429676
  • Postalcode : 750691870
  • Address : 4717 MEDICAL CENTER DR

Additional identifiers

  • Identifier: 284096901
  • Code / Type : 5 - MEDICAID
  • Identifier state : TX

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QE0700X
  • License number: 110064
  • License state: TX

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

Click to Show Map
  • GREAT DIALYSIS LLC
  • Address : 4717 MEDICAL CENTER DR
  • Region : MCKINNEY, TX
  • NPI : 1932413010
  • Phone : 9725420495
  • Fax : 9725429676
  • Postalcode : 750691870

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 2537334500
  • Title or position : CHIEF ACCOUNTING OFC & TREASURER

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address4717 MEDICAL CENTER DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameMCKINNEY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code750691870
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number9725420495
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number9725429676
The fax number associated with the location address of the provider being identified.
NPI1932413010
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QE0700X
Provider Enumeration Date08.02.2010
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated10/29/2018
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)GREAT DIALYSIS LLC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameMCKINNEY DIALYSIS
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address5200 VIRGINIA WAY
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressL & C DEPT
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameBRENTWOOD
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTN
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code370277569
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6153416764
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number8337816999
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameHILGER
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameJAMES
The first name of the authorized official
Authorized Official Middle NameK
The middle name of the authorized official
Authorized Official Title or PositionCHIEF ACCOUNTING OFC & TREASURER
The title or position of the authorized official
Authorized Official Telephone Number2537334500
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QE0700X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Provider License Number 1110064
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1TX
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1284096901
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1TX
Other Provider Identifier State #1
X

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