PORTAGE DIALYSIS CENTER
NPI 1003921842
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Portage, IN
About Portage Dialysis Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PORTAGE DIALYSIS CENTER (NPI 1003921842) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Portage, Indiana and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through December 8, 2027 and lists Mark Fawcett, Treasurer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 15D0968363
Portage Dialysis Center Portage Dialysis · Portage, INFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Everest Healthcare Indiana, Inc.'s NPI number?
The NPI number for Everest Healthcare Indiana, Inc. is 1003921842. It was assigned to this organization in the NPPES registry on August 20, 2006. The provider is doing business as Portage Dialysis Center.
Where is Everest Healthcare Indiana, Inc. located?
Everest Healthcare Indiana, Inc. is located at 5972 Us Highway 6, Portage, IN 46368. The listed phone number is (219) 764-3637.
What is Everest Healthcare Indiana, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.
Does Everest Healthcare Indiana, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 15D0968363) is associated with this NPI, valid through December 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Everest Healthcare Indiana, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Portage Dialysis Center · NPI 1003921842
End-Stage Renal Disease (ESRD) Treatment organization in Portage, Indiana. Organization record, active in the CMS NPPES registry since August 20, 2006.
## Identity
- **NPI:** 1003921842 (Entity type: Organization)
- **Enumerated:** August 20, 2006
- **Primary specialty:** Clinic/Center - End-Stage Renal Disease (ESRD) Treatment · taxonomy 261QE0700X
- **Legal business name:** Everest Healthcare Indiana, Inc.
- **Organization subpart:** No
- **Authorized official:** Mark Fawcett, TREASURER
## Practice location
- **Address:** 5972 US HIGHWAY 6, Portage, IN 46368-4946
- **Phone:** (219) 764-3637
## Record status
- **NPPES last updated:** August 22, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003921842) · Data from the CMS NPPES public registry.