LAKE AVENUE DIALYSIS
NPI 1174579551
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Fort Wayne, IN

Q: What is Isd Renal Inc's NPI number?

The NPI number for Isd Renal Inc is 1174579551. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Lake Avenue Dialysis.

Q: What is Isd Renal 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.

Q: When was this NPI record last updated?

The NPPES record for Isd Renal Inc was last updated on July 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since May 26, 2006

3909 LAKE AVE, FORT WAYNE, IN 46805(260) 420-2666(260) 424-2036 Get Directions Write a Review

NPPES record last updated: July 3, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lake Avenue Dialysis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE AVENUE DIALYSIS (NPI 1174579551) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Fort Wayne, Indiana and active in the NPI registry since May 2006. The organization lists James K Hilger, Chief Accounting Officer, as its authorized official.

NPPES Registry Identity

NPI1174579551

Entity TypeOrganization

Primary Taxonomy261QE0700X

Legal Business NameISD RENAL INC

Location Address3909 LAKE AVEFort Wayne, IN 46805-5545

Mailing Address5200 Virginia Way, Licensure & CertificationBrentwood, TN 37027-7569 · (615) 341-6374

Phone(260) 420-2666

Fax(260) 424-2036

Organization SubpartNo

Authorized OfficialJames K HilgerChief Accounting Officer · (253) 272-1916

Enumeration DateMay 26, 2006

Last NPPES UpdateJuly 3, 2012

✔ NPI 1174579551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities

Taxonomy Code261QE0700X

3909 LAKE AVE, Fort Wayne, IN 46805

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Other Names 1

Doing Business AsLake Avenue Dialysis

Other Identifiers 1

Medicare OSCAR/certification152508

Frequently 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 Isd Renal Inc's NPI number?

The NPI number for Isd Renal Inc is 1174579551. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is doing business as Lake Avenue Dialysis.

Where is Isd Renal Inc located?

Isd Renal Inc is located at 3909 Lake Ave, Fort Wayne, IN 46805. The listed phone number is (260) 420-2666.

What is Isd Renal 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.

When was this NPI record last updated?

The NPPES record for Isd Renal Inc was last updated on July 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.