Irc-Sutter Health Jackson LLC

Primary specialty

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

Legal business name

IRC-SUTTER HEALTH JACKSON LLC

Practice address

12030 Industry Blvd
Jackson, CA 95642-9371

Phone

(209) 273-3060

Fax

(209) 273-3374

NPI assigned

Nov 15, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Sara Anne Brady

Title

Authorized Official

Phone

(208) 371-7878

Specialties & licenses 1

Addresses

Other names 1

• INNOVATIVE RENAL CARE JACKSON DIALYSIS CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Innovative Renal Care JacksonCCN 752608

Ownership

Profit

Certified

Oct 23, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Innovative Dialysis Systems

Dialysis stations

11

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

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

• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Los Banos, CA
  • NPI 1366896300

  Member Of

  NPD member

Locations

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Adarsh Bhat, M.D.

  • Nephrology Physician
  • Roseville, CA
  • NPI 1861443228

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1124893615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 INDUSTRY BLVD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429371",
            "telephone_number": "209-273-3060",
            "fax_number": "209-273-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12030 INDUSTRY BLVD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429371",
            "telephone_number": "209-273-3060",
            "fax_number": "209-273-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRC-SUTTER HEALTH JACKSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-15",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "208-371-7878",
        "authorized_official_name_prefix": "Mrs."
    },
    "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": "INNOVATIVE RENAL CARE JACKSON DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "INNOVATIVE RENAL CARE JACKSON DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christy Hobgood
• Drew D. Hood, MD
• Hospice of Amador & Calaveras
• Hospitalist Medicine Physicians of California - Jackson, PC
• Maria Williamson House, M.D.
• Fatima Jacobo
• Denise Ann James, MFT
• Abdul Jawid
• Loni D Jay, MD
• JL Registered Nursing Home Healthcare, Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Jackson, CA
• Providers in Jackson, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.