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KENOSHA KIDNEY DIALYSIS LLC
NPI 1730219924
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Kenosha, WI

Active since March 06, 2007
6125 GREEN BAY RD, SUITE 100, KENOSHA, WI 53142(262) 652-1776(262) 652-2702 Get Directions Write a Review

NPPES record last updated: March 16, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenosha Kidney Dialysis Llc NPPES

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

KENOSHA KIDNEY DIALYSIS LLC (NPI 1730219924) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Kenosha, Wisconsin and active in the NPI registry since March 2007. The organization lists Jonathan Wilcox, Cfo, as its authorized official.

NPPES Registry Identity

NPI1730219924
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameKENOSHA KIDNEY DIALYSIS LLC
Location Address6125 GREEN BAY RD, SUITE 100Kenosha, WI 53142-2942
Mailing Address6125 Green Bay Rd, Suite 100Kenosha, WI 53142-2942 · (262) 652-1776 · Fax (262) 652-2702
Phone(262) 652-1776
Fax(262) 652-2702
Organization SubpartNo
Authorized OfficialJonathan WilcoxCfo · (978) 922-3080
Enumeration DateMarch 6, 2007
Last NPPES UpdateMarch 16, 2017
✔ NPI 1730219924 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
6125 GREEN BAY RD, Kenosha, WI 53142
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Other Identifiers 2

Medicare OSCAR/certification522574WI
Medicaid42064600WI

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SURYA MEDICAL GROUP SC
Family Medicine (Geriatric Medicine)
6125 GREEN BAY RD, SUITE 100
KENOSHA, WI 53142
Kenosha County (262) 564-8636
DR. LAURIE ANN ROBERTSON O.D.
Optometrist
6125 GREEN BAY RD, SUITE 800
KENOSHA, WI 53142
Kenosha County (262) 654-0726
DR. FRANK SERRECCHIA M.D.
Pediatrics
6125 GREEN BAY RD, SUITE 700
KENOSHA, WI 53142
Kenosha County (262) 654-8633
V. STEPHEN SLANA , M.D.,S.C.
Durable Medical Equipment & Medical Supplies
6125 GREEN BAY RD, SUITE 800
KENOSHA, WI 53142
Kenosha County (262) 654-0726
GANESH N PULLA M.D
Internal Medicine (Nephrology)
6125 GREEN BAY RD, 100
KENOSHA, WI 53142
Kenosha County (262) 564-8636
KIDNEY REPLACEMENT THERAPIES, SC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
6125 GREEN BAY RD, SUITE 100
KENOSHA, WI 53142
Kenosha County (262) 564-8636
VICTOR STEPHEN SLANA MD
Ophthalmology
6125 GREEN BAY RD, STE 800
KENOSHA, WI 53142
Kenosha County (262) 654-0726
BHARATHI PULLA M.D
Family Medicine (Adolescent Medicine)
6125 GREEN BAY RD
KENOSHA, WI 53142
Kenosha County (262) 564-8636

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 Kenosha Kidney Dialysis LLC's NPI number?

The NPI number for Kenosha Kidney Dialysis LLC is 1730219924. It was assigned to this organization in the NPPES registry on March 6, 2007.

Where is Kenosha Kidney Dialysis LLC located?

Kenosha Kidney Dialysis LLC is located at 6125 Green Bay Rd Suite 100, Kenosha, WI 53142. The listed phone number is (262) 652-1776.

What is Kenosha Kidney Dialysis LLC'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 Kenosha Kidney Dialysis LLC was last updated on March 16, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.