LAKE AVENUE DIALYSIS
NPI 1174579551
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Fort Wayne, IN
NPI Status: Active since May 26, 2006
Contact Information
3909 LAKE AVE
FORT WAYNE, IN
ZIP 46805
Phone: (260) 420-2666
Fax: (260) 424-2036
- Organization
- Clinic/Center
- End-Stage Renal Disease (ESRD) Treatment
About LAKE AVENUE DIALYSIS
This page provides the complete NPI Profile along with additional information for Lake Avenue Dialysis, a provider established in Fort Wayne, Indiana operating as a Clinic/center, focusing in end-stage renal disease (esrd) treatment . The healthcare provider is registered in the NPI registry with number 1174579551 assigned on May 2006. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Lake Avenue Dialysis. The authorized official of this NPI record is Mr. James K Hilger (Chief Accounting Officer)
- NPI
- 1174579551
- Provider Legal Name
- ISD RENAL INC
- Other Organization Name
- LAKE AVENUE DIALYSIS
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3909 LAKE AVE FORT WAYNE, IN 46805
- Location Phone
- (260) 420-2666
- Location Fax
- (260) 424-2036
- Mailing Address
- 5200 VIRGINIA WAY LICENSURE & CERTIFICATION BRENTWOOD, TN 37027
- Mailing Phone
- (615) 341-6374
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-26-2006
- Last Update Date
- 07-03-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center End-Stage Renal Disease (ESRD) Treatment
- Taxonomy Code
- 261QE0700X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 152508 | MEDICARE OSCAR/CERTIFICATION (06) |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 5 | 7 | 9 | 5 | 5 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 10 | 7 | 18 | 5 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 0 + 7 + 1 + 8 + 5 + 1 + 0 + 24 = 59 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 59 = 1 | 1 | ||||||||
The NPI number 1174579551 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174579551, enumerated in the NPI registry as an "organization" on May 26, 2006
The provider is located at 3909 Lake Ave Fort Wayne, In 46805 and the phone number is (260) 420-2666
This medical organization specializes in Clinic/Center with taxonomy code 261QE0700X with a focus in End-Stage Renal Disease (ESRD) Treatment
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on May 26, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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