Provider Demographics
NPI:1801837372
Name:DSI RENAL INC
Entity Type:Organization
Organization Name:DSI RENAL INC
Other - Org Name:DSI LEES SUMMIT RENAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-0134
Mailing Address - Street 1:511 UNION ST
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-1733
Mailing Address - Country:US
Mailing Address - Phone:615-467-0134
Mailing Address - Fax:615-234-2422
Practice Address - Street 1:100 NE MISSOURI ROAD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086
Practice Address - Country:US
Practice Address - Phone:816-524-3312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO91284051OtherBCBS KANSAS CITY
MO262617Medicare Oscar/Certification