NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Blue Mountain Kidney Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pendleton, OR
National Provider Identifier
1215055827
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TOTAL RENAL CARE INC
Doing business as
Blue Mountain Kidney Center
Practice address
72556 Coyote Rd
Pendleton, OR 97801-1002
Phone
(541) 966-8563
Fax
(541) 966-8573
NPI assigned
Mar 26, 2007
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Samuel T Wey
Title
VP Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

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

Addresses

Primary practice location

72556 Coyote Rd
Pendleton, OR 97801-1002

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other names 1

  • Blue Mountain Kidney Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070927001112 OR Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Pendleton, OR

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Blue Mountain Kidney CenterCCN 382554
Overall star rating
5.0 of 5
Ownership
Profit
Certified
Dec 19, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
13

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Hernando Kidney Center758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

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

Locations

72556 Coyote Rd
Pendleton, OR 97801
Phone (509) 897-8100

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1215055827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72556 COYOTE RD",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978011002",
            "telephone_number": "541-966-8563",
            "fax_number": "541-966-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "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": "Blue Mountain Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Mountain Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.