OrganizationActive
Southwood Park Dialysis LLC
NPI 1043676802 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Prairieville, LA
Provider details
- NPI number
- 1043676802
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- John Winstel, Chief Accounting Officer(253) 733-4501
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17123 Commerce Centre Dr
Prairieville, LA 70769-3481
Phone: (225) 877-2001
Fax: (225) 877-2002
Street-level locationGet directions
Mailing address
5200 Virginia Way
Brentwood, TN 37027-7569
Other names (DBA / former)
- Doing business as
- Prairieville Dialysis
- Doing business as
- Prairieville Dialysis
Registry dates
- Enumerated
- 2016-01-11
- Last updated
- 2022-09-14
- Certified
- 2022-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.