OrganizationActive
Midwest Legacy Capital LLC
NPI 1972008704 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Black Creek, WI
Provider details
- NPI number
- 1972008704
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Thomas Dudley, Ceo(920) 915-5202
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
W4233 State Rd 54
Black Creek, WI 54106-8633
Phone: (920) 915-5202
Approximate (ZIP-level) locationGet directions
Mailing address
W4233 State Rd 54
Black Creek, WI 54106-8633
Other names (DBA / former)
- Doing business as
- At Home Kidneycare
- Doing business as
- At Home Kidneycare
Registry dates
- Enumerated
- 2018-03-26
- Last updated
- 2018-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.