Active NPI
Dialysis Clinic Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pocatello, ID
National Provider Identifier
1083232979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- DIALYSIS CLINIC INC
- Practice address
- 2001 Bench Rd
Pocatello, ID 83201-2033 - Phone
- (208) 646-3160
- Fax
- (208) 646-3161
- NPI assigned
- Jul 8, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donovan Schultz
- Title
- President
- Phone
- (615) 327-3061
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
2001 Bench Rd
Pocatello, ID 83201-2033
Mailing address
1633 Church St Ste 500
Nashville, TN 37203-2948
Phone (615) 342-0498
Other names 1
- DCI Pocatello
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Brownsville, TN
- NPI 1013940493
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594166400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696377600000",
"number": "1083232979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 CHURCH ST STE 500",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372032948",
"telephone_number": "615-342-0498",
"fax_number": "615-963-9730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 BENCH RD",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832012033",
"telephone_number": "208-646-3160",
"fax_number": "208-646-3161"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIALYSIS CLINIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2020-07-08",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A",
"authorized_official_last_name": "SCHULTZ",
"authorized_official_first_name": "DONOVAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "615-327-3061"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "DCI Pocatello",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "DCI Pocatello",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.