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  7. NPI Record 1285697706

U S RENAL CARE CARLISLE DIALYSIS
Complete NPI Record 1285697706
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Carlisle, PA


Overall Rating: 4 out of 5 stars

NPI Status: Active since April 07, 2006

Contact Information

101 NOBLE BLVD
SUITE 103
CARLISLE, PA
ZIP 17013
Phone: (717) 258-3099
Fax: (717) 258-3632

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Second Line Business Practice Location Address
  16. Provider Business Practice Location Address City Name
  17. Provider Business Practice Location Address State Name
  18. Provider Business Practice Location Address Postal Code
  19. Provider Business Practice Location Address Country Code If outside U S
  20. Provider Business Practice Location Address Telephone Number
  21. Provider Business Practice Location Address Fax Number
  22. Provider Enumeration Date
  23. Last Update Date
  24. Authorized Official Last Name
  25. Authorized Official First Name
  26. Authorized Official Middle Name
  27. Authorized Official Title or Position
  28. Authorized Official Telephone Number
  29. Healthcare Provider Taxonomy Code 1
  30. Healthcare Provider Primary Taxonomy Switch 1
  31. Other Provider Identifier 1
  32. Other Provider Identifier Type Code 1
  33. Other Provider Identifier State 1
  34. Other Provider Identifier Issuer 1
  35. Other Provider Identifier 2
  36. Other Provider Identifier Type Code 2
  37. Other Provider Identifier State 2
  38. Other Provider Identifier Issuer 2
  39. Other Provider Identifier 3
  40. Other Provider Identifier Type Code 3
  41. Other Provider Identifier State 3
  42. Other Provider Identifier Issuer 3
  43. Other Provider Identifier 4
  44. Other Provider Identifier Type Code 4
  45. Other Provider Identifier State 4
  46. Other Provider Identifier Issuer 4
  47. Other Provider Identifier 5
  48. Other Provider Identifier Type Code 5
  49. Other Provider Identifier State 5
  50. Other Provider Identifier Issuer 5
  51. Other Provider Identifier 6
  52. Other Provider Identifier Type Code 6
  53. Other Provider Identifier State 6
  54. Other Provider Identifier Issuer 6
  55. Other Provider Identifier 7
  56. Other Provider Identifier Type Code 7
  57. Other Provider Identifier State 7
  58. Other Provider Identifier Issuer 7
  59. Other Provider Identifier 8
  60. Other Provider Identifier Type Code 8
  61. Other Provider Identifier State 8
  62. Other Provider Identifier Issuer 8
  63. Other Provider Identifier 9
  64. Other Provider Identifier Type Code 9
  65. Other Provider Identifier State 9
  66. Other Provider Identifier 10
  67. Other Provider Identifier Type Code 10
  68. Other Provider Identifier State 10
  69. Other Provider Identifier Issuer 10
  70. Other Provider Identifier 11
  71. Other Provider Identifier Type Code 11
  72. Other Provider Identifier State 11
  73. Other Provider Identifier Issuer 11
  74. Other Provider Identifier 12
  75. Other Provider Identifier Type Code 12
  76. Other Provider Identifier State 12
  77. Other Provider Identifier Issuer 12
  78. Other Provider Identifier 13
  79. Other Provider Identifier Type Code 13
  80. Other Provider Identifier State 13
  81. Other Provider Identifier Issuer 13
  82. Other Provider Identifier 14
  83. Other Provider Identifier Type Code 14
  84. Other Provider Identifier State 14
  85. Other Provider Identifier Issuer 14
  86. Other Provider Identifier 15
  87. Other Provider Identifier Type Code 15
  88. Other Provider Identifier State 15
  89. Other Provider Identifier Issuer 15
  90. Other Provider Identifier 16
  91. Other Provider Identifier Type Code 16
  92. Other Provider Identifier State 16
  93. Other Provider Identifier Issuer 16
  94. Other Provider Identifier 17
  95. Other Provider Identifier Type Code 17
  96. Other Provider Identifier State 17
  97. Other Provider Identifier Issuer 17
  98. Other Provider Identifier 18
  99. Other Provider Identifier Type Code 18
  100. Other Provider Identifier State 18
  101. Other Provider Identifier Issuer 18
  102. Other Provider Identifier 19
  103. Other Provider Identifier Type Code 19
  104. Other Provider Identifier State 19
  105. Other Provider Identifier Issuer 19
  106. Is Organization Subpart
  107. Parent Organization LBN
  108. Parent Organization TIN
  109. Authorized Official Name Prefix Text

Complete NPI Dataset

This page represents the complete record for NPI 1285697706. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1285697706
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
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).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: U S RENAL CARE CARLISLE DIALYSIS
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 3
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 Address: PO BOX 19119
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 Business Mailing Address City Name: JONESBORO
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: AR
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 Code: 724036601
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 Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 8709315400
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 Number: 8709315418
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’’.
Provider First Line Business Practice Location Address: 101 NOBLE BLVD
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 Second Line Business Practice Location Address: SUITE 103
The second 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 Name: CARLISLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: PA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 170134100
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 Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7172583099
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 7172583632
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 4/7/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 6/21/2018
The date that a record was last updated or changed.
Authorized Official Last Name: WEINBERG
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 Name: THOMAS
The first name of the authorized official.
Authorized Official Middle Name: L.
The middle name of the authorized official.
Authorized Official Title or Position: VICE PRESIDENT & SECRETARY
The title or position of the authorized official.
Authorized Official Telephone Number: 2142134700
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261QE0700X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: PA
Other Provider Identifier Issuer 1: AARP/UNITED HEALTHCARE
Other Provider Identifier 2: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: PA
Other Provider Identifier Issuer 2: CARPENTERS HEALTH
Other Provider Identifier 3: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: PA
Other Provider Identifier Issuer 3: FLEET RESERVE
Other Provider Identifier 4: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: PA
Other Provider Identifier Issuer 4: FRANK J SIRACUSA
Other Provider Identifier 5: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: PA
Other Provider Identifier Issuer 5: AUSA LIFE INSURANCE
Other Provider Identifier 6: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: PA
Other Provider Identifier Issuer 6: CIGNA
Other Provider Identifier 7: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 7: PA
Other Provider Identifier Issuer 7: BOARD OF PENSIONS
Other Provider Identifier 8: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 8: PW
Other Provider Identifier Issuer 8: CAPITAL BLUE CROSS
Other Provider Identifier 9: 0016627710001
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 9: PA
Other Provider Identifier 10: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 10: PA
Other Provider Identifier Issuer 10: AMERICAN MARITIME
Other Provider Identifier 11: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 11: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 11: PA
Other Provider Identifier Issuer 11: COMBINED INSURANCE
Other Provider Identifier 12: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 12: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 12: PA
Other Provider Identifier Issuer 12: CORNING HEALTH
Other Provider Identifier 13: 5694652
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 13: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 13: PA
Other Provider Identifier Issuer 13: AETNA
Other Provider Identifier 14: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 14: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 14: PA
Other Provider Identifier Issuer 14: ADVANTRA
Other Provider Identifier 15: 1520690
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 15: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 15: PA
Other Provider Identifier Issuer 15: GATEWAY
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.
Other Provider Identifier 16: 1662771
The city name in the location address of the provider being identified.
Other Provider Identifier Type Code 16: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 16: PA
Other Provider Identifier Issuer 16: HEALTHMATE
Other Provider Identifier 17: 392627
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 17: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 17: PA
The date the provider was assigned a unique identifier (assigned an NPI).
Other Provider Identifier Issuer 17: CAREFIRST
Other Provider Identifier 18: =========
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 18: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 18: PA
Other Provider Identifier Issuer 18: TRICARE
Other Provider Identifier 19: PPA01553
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 19: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 19: PA
Other Provider Identifier Issuer 19: PA CHRONIC RENAL PROGRAM
Is Organization Subpart: Y
Parent Organization LBN: U S RENAL CARE INC
Parent Organization TIN: UNAVAIL
Authorized Official Name Prefix Text: MR.