{"npi":"1508821471","type":"NPI-2","status":"active","name":{"display":"La Grange Dialysis LLC","other":[],"organization_name":"LA GRANGE DIALYSIS LLC","authorised_official":"Thomas Usilton"},"specialty":{"primary_taxonomy":"261QE0700X","primary_taxonomy_description":"End-Stage Renal Disease (ESRD) Treatment Clinic/Center","slug":"end-stage-renal-disease-esrd-treatment-clinic-center","schema_org_specialty":null,"all":[{"code":"261QE0700X","description":"End-Stage Renal Disease (ESRD) Treatment Clinic/Center","primary":true,"state":"KY","license":"300169"}]},"addresses":[{"purpose":"LOCATION","street_1":"240 PARKER DR","city":"LA GRANGE","state":"KY","postal_code":"400311200","country_code":"US","phone":"5022225527","fax":"5022222258"},{"purpose":"MAILING","street_1":"5200 VIRGINIA WAY","city":"BRENTWOOD","state":"TN","postal_code":"370277569","country_code":"US","street_2":"STE. 400 L&C","phone":"6153204218","fax":"3032097825"}],"license":{"state":"KY","number":"300169"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"39000880","state":"KY","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-04-20","last_updated":"2007-07-11","_meta":{"source":"NPPES","snapshot_date":"2007-07-11","doc_url":"https://findmynpi.com/api"}}