OrganizationActive
Renal Treatment Centers - Southeast, Lp
NPI 1255397170 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fort Walton Beach, FL
Provider details
- NPI number
- 1255397170
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Thomas Usilton, Group Vice President(770) 541-7922
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
1110 Hospital Rd
Suite a
Fort Walton Beach, FL 32547-6644
Phone: (850) 862-6989
Fax: (850) 862-0014
Street-level locationGet directions
Mailing address
5200 Virginia Way
Brentwood, TN 37027-7569
Other names (DBA / former)
- Doing business as
- Fort Walton Beach Dialysis
Registry dates
- Enumerated
- 2006-04-21
- Last updated
- 2007-07-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.