NPIMap

Organization Active NPI

Saint Alphonsus Nephrology Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ontario, OR
National Provider Identifier
1073504635
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
170009 Issued in OR
Legal business name
SAINT ALPHONSUS NEPHROLOGY CENTER
Practice address
515 East LN
Ontario, OR 97914-3953
Phone
(541) 889-9557
Fax
(541) 881-8721
NPI assigned
Nov 2, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jan M Jacobs
Title
Accounts Receivable Manager
Phone
(208) 367-3076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 170009 OR Primary

Addresses

Primary practice location

515 East LN
Ontario, OR 97914-3953

Mailing address

5610 Gage St
Ste B
Boise, ID 83706-1349
Phone (208) 367-3076

National Provider Directory

National Provider Directory
Tax ID family
Saint Alphonsus Nephrology Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073504635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 GAGE ST",
            "address_2": "STE B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061349",
            "telephone_number": "208-367-3076",
            "fax_number": "208-367-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 EAST LN",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143953",
            "telephone_number": "541-889-9557",
            "fax_number": "541-881-8721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ALPHONSUS NEPHROLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "208-367-3076"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OR",
            "license": "170009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.