Nra Ada Oklahoma LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

N/A Issued in OK

Legal business name

NRA ADA OKLAHOMA LLC

Doing business as

Ada Dialysis Center

Practice address

324 NW J.a. Richardson Loop
Ada, OK 74820-2017

Phone

(580) 421-9131

Fax

(580) 421-9135

NPI assigned

Jun 1, 2006

Last updated

Jun 5, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Mark R Fawcett

Title

Treasurer

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ada Dialysis Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• National Medical Care, Inc.

  dba Renal Care Center of North Georgia Bma

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Canton, GA
  • NPI 1871605600

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven J Bander, M.D.

  • Nephrology Physician
  • Des Peres, MO
  • NPI 1750496303
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1083651806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 NW J A RICHARDSON LOOP",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202017",
            "telephone_number": "580-421-9131",
            "fax_number": "580-421-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 NW J.A. RICHARDSON LOOP",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202017",
            "telephone_number": "580-421-9131",
            "fax_number": "580-421-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NRA ADA OKLAHOMA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OK",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE OF WAIVE",
            "identifier": "37D1049560",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200100430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ada Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Troy R Norred, MD
• Timothy E Norris
• Jordan Northam
• Aubrie Morgan Northcutt, DO
• Nova Oral Surgery LLC (Southeast Oklahoma Oral and Maxillofacial)
• Priscillah Nyakundi
• Sidney Michael O'Grady, M.S., R.PH., D.PH.
• Stephen O'Grady, MD
• Thomas Joseph Godinez O'Meara, DMD
• Patrick J O'Neill, DO

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ada, OK
• Providers in Ada, OK by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.