LIBERTY DIALYSIS - CRAWFORDSVILLE – NPI #1336239730
Clinic/Center

LIBERTY DIALYSIS - CRAWFORDSVILLE is an AHC clinic located in CRAWFORDSVILLE, IN. NPPES has assigned the NPI number 1336239730 to LIBERTY DIALYSIS - CRAWFORDSVILLE on October 13, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LIBERTY DIALYSIS - CRAWFORDSVILLE” is a dba name, the actual legal business name for this organization is LIBERTY DIALYSIS - LAFAYETTE, LLC. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 3 years ago on Oct 17, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LIBERTY DIALYSIS - CRAWFORDSVILLE below.

NPI Profile for
LIBERTY DIALYSIS - LAFAYETTE, LLC

NPI Number
1336239730
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LIBERTY DIALYSIS - LAFAYETTE, LLC
Doing Business As (dba): LIBERTY DIALYSIS - CRAWFORDSVILLE
Primary location
1710 LAFAYETTE RD
CRAWFORDSVILLE, IN 47933-1033
Phone: (765) 359-1613 Fax: (765) 359-1614
Mailing address
Same as primary location
Organization Subpart
Yes - LIBERTY DIALYSIS - CRAWFORDSVILLE is subpart of another organization.
Authorized Official
BARRY BLANTON
VICE PRESIDENT
Phone: (781) 699-9000
Updated
Certification Date
Oct 17, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.667.2
Content Type
CSV
Affiliation
Y
Endpoint Location
100 N 6TH ST STE 900A,
MINNEAPOLIS, MN 77025-1669