Southeastern Renal Dialysis L.c.
NPI 1609988617 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fort Madison, IA
Enrolled with Medicare as Part a Provider - End-Stage Renal Disease Facility (esrd) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southeastern Renal Dialysis L.c. is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center organization in Fort Madison, IA (NPI 1609988617).
Provider details
- NPI number
- 1609988617
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Southeastern Renal Dialysis L.c.
- Organization subpart
- Yes
- Authorized official
- Mary Liechty, Administrator(319) 385-6728
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
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
Mailing address
Registry dates
- Enumerated
- 2006-08-31
- Last updated
- 2012-03-16
Frequently asked questions
- What is Southeastern Renal Dialysis L.c.'s NPI number?
- Southeastern Renal Dialysis L.c.'s National Provider Identifier (NPI) is 1609988617, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southeastern Renal Dialysis L.c.?
- Southeastern Renal Dialysis L.c. is classified in the NPPES registry as End-Stage Renal Disease (ESRD) Treatment Clinic/Center (Ambulatory Health Care Facilities).
- Where is Southeastern Renal Dialysis L.c. located?
- Southeastern Renal Dialysis L.c.'s practice location on file with NPPES is 4703 Avenue L, Fort Madison, IA 52627-9505.
- What is Southeastern Renal Dialysis L.c.'s phone number?
- The practice phone number listed in the NPPES registry for Southeastern Renal Dialysis L.c. is (319) 372-7996.
- Does Southeastern Renal Dialysis L.c. accept Medicare?
- Southeastern Renal Dialysis L.c. 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 Southeastern Renal Dialysis L.c.?
- The authorized official listed on Southeastern Renal Dialysis L.c.'s NPPES record is Mary Liechty, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southeastern Renal Dialysis L.c.'s NPI active?
- Yes — Southeastern Renal Dialysis L.c.'s NPI (1609988617) is active in the NPPES registry as of the last update on 2012-03-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.