{"npi":"1629596267","type":"NPI-2","status":"active","name":{"display":"Isd Renal INC","other":[],"organization_name":"ISD RENAL INC","authorised_official":"Samuel Wey"},"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":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"2912 W TUSCARAWAS ST","city":"CANTON","state":"OH","postal_code":"447084643","country_code":"US","phone":"3304580150","fax":"3304580164"},{"purpose":"MAILING","street_1":"5200 VIRGINIA WAY","city":"BRENTWOOD","state":"TN","postal_code":"370277569","country_code":"US","street_2":"ATT: L&C DEPT","phone":"6152383051","fax":"8002468346"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"0277646","state":"OH","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20171117001391","type_code":"00-03","type_desc":"PART A PROVIDER - END-STAGE RENAL DISEASE FACILITY (ESRD)","state":"OH","pac_id":"6507053790"}]},"enumeration_date":"2017-09-05","last_updated":"2024-01-04","_meta":{"source":"NPPES","snapshot_date":"2024-01-04","doc_url":"https://findmynpi.com/api"}}