NPIMap

Organization Active NPI

Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Browning, MT
National Provider Identifier
1124043815
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
10379 Issued in MT
Legal business name
DIALYSIS CLINIC INC.
Practice address
760 Hopsital Circle,
Browning, MT 59417
Phone
(406) 338-7472
Fax
(406) 338-3426
NPI assigned
Jul 13, 2006
Last updated
Apr 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Authorized official

Name
Mr. William E. Wood II
Title
President
Phone
(615) 327-3061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 10379 MT Primary

Addresses

Primary practice location

760 Hopsital Circle,
Browning, MT 59417

Mailing address

2411 Village LN
Billings, MT 59102-2491
Phone (406) 338-7472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100225000208 MT Part A Provider - End-Stage Renal Disease Facility (ESRD) 4284541129 Practice locations: Browning, MT

National Provider Directory

National Provider Directory
Tax ID family
Tuncer Someren MD238 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

135 Commons Way
Kalispell, MT 59901
Phone (406) 752-7406

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rancho Dialysis ClinicSacramento, CA, CCN 552519 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 24, 2003
Dec 24, 2003

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1124043815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 VILLAGE LN",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591022491",
            "telephone_number": "406-338-7472",
            "fax_number": "406-338-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 HOPSITAL CIRCLE,",
            "city": "BROWNING",
            "state": "MT",
            "postal_code": "59417",
            "telephone_number": "406-338-7472",
            "fax_number": "406-338-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MT",
            "license": "10379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Browning, MT

Sources for this page

Verify at the official NPI Registry.