Fresenius Medical Care Cline Dialysis, LLC

Primary specialty

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

Legal business name

FRESENIUS MEDICAL CARE CLINE DIALYSIS, LLC

Doing business as

Fresenius Medical Care Cline Family Dialysis Center

Practice address

1040 N 18TH St
Centerville, IA 52544-1118

Phone

(641) 437-1302

Fax

(641) 437-1080

NPI assigned

Dec 20, 2012

Last updated

Aug 7, 2021By 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

Barry L. Blanton

Title

Vice President

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• FRESENIUS MEDICAL CARE CLINE FAMILY 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

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628294400000",
    "number": "1164768099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 N 18TH ST",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525441118",
            "telephone_number": "641-437-1302",
            "fax_number": "641-437-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 N 18TH ST",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525441118",
            "telephone_number": "641-437-1302",
            "fax_number": "641-437-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE CLINE DIALYSIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2012-12-20",
        "last_updated": "2021-08-07",
        "certification_date": "2021-08-07",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRESENIUS MEDICAL CARE CLINE FAMILY DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurel Lea Eicher, RN, MSN, ACGNP
• Brittany Ann Enlow, ARNP, FNP-C
• Tabitha Farris
• First Resources Corp
• David B Fraser, MD
• Bailee Geitzenauer, ARNP, FNP-C
• Golden Age Properties LLC (Golden Age Care Center)
• Golden Age, Inc. (Golden Age Skilled Nursing & Rehab)
• Lauren Nicole Gonnerman
• Paula Sue Gordy, LISW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Centerville, IA
• Providers in Centerville, IA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2021; 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.