Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Isd Renal Inc

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1174579551

Isd Renal Inc is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Wayne, Indiana. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3909 Lake Ave
Fort Wayne, IN 46805-5545
Phone: (260) 420-2666
Fax: (260) 424-2036
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary) Taxonomy 261QE0700X

Record details

NPI number1174579551
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Hilger — Chief Accounting Officer · (253) 272-1916
Other names Lake Avenue Dialysis
NPI enumeratedMay 26, 2006
Last updated in NPPESJuly 3, 2012
Mailing address5200 Virginia Way, Licensure & Certification, Brentwood, TN 37027-7569

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