Lake Gray Dialysis Center LLC
NPI 1588017784 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Jacksonville, FL
Enrolled with Medicare as Part a Provider - End-Stage Renal Disease Facility (esrd) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake Gray Dialysis Center LLC is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center organization in Jacksonville, FL (NPI 1588017784).
Provider details
- NPI number
- 1588017784
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Sara Brady, Chief Nursing Officer(208) 371-7878
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
Mailing address
Other names (DBA / former)
- Doing business as
- Ara Collins Road Dialysis Center
- Doing business as
- Ara Collins Road Dialysis Center
Registry dates
- Enumerated
- 2016-07-22
- Last updated
- 2023-01-10
- Certified
- 2023-01-10
Frequently asked questions
- What is Lake Gray Dialysis Center LLC's NPI number?
- Lake Gray Dialysis Center LLC's National Provider Identifier (NPI) is 1588017784, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Gray Dialysis Center LLC?
- Lake Gray Dialysis Center LLC is classified in the NPPES registry as End-Stage Renal Disease (ESRD) Treatment Clinic/Center (Ambulatory Health Care Facilities).
- Where is Lake Gray Dialysis Center LLC located?
- Lake Gray Dialysis Center LLC's practice location on file with NPPES is 6196 Lake Gray Blvd, Jacksonville, FL 32244-7503.
- What is Lake Gray Dialysis Center LLC's phone number?
- The practice phone number listed in the NPPES registry for Lake Gray Dialysis Center LLC is (904) 772-0933.
- Does Lake Gray Dialysis Center LLC accept Medicare?
- Lake Gray Dialysis Center LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake Gray Dialysis Center LLC?
- The authorized official listed on Lake Gray Dialysis Center LLC's NPPES record is Sara Brady, Chief Nursing Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Gray Dialysis Center LLC's NPI active?
- Yes — Lake Gray Dialysis Center LLC's NPI (1588017784) is active in the NPPES registry as of the last update on 2023-01-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.