NPIMap

Organization Active NPI

Pacific Northwest Renal Services, L.L.C.

Doing business as PNRS Hollywood Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
National Provider Identifier
1255443156
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
PACIFIC NORTHWEST RENAL SERVICES, L.L.C.
Doing business as
PNRS Hollywood Dialysis Center
Practice address
2824 NE Wasco St
Portland, OR 97232-1772
Phone
(503) 493-8227
Fax
(503) 493-8502
NPI assigned
Aug 31, 2006
Last updated
Oct 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

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

Addresses

Primary practice location

2824 NE Wasco St
Portland, OR 97232-1772

Mailing address

2824 NE Wasco St
Portland, OR 97232-1772
Phone (503) 493-8227

Other names 1

  • PNRS HOLLYWOOD DIALYSIS CENTER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

National Provider Directory

National Provider Directory

Member of 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1255443156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 NE WASCO ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321772",
            "telephone_number": "503-493-8227",
            "fax_number": "503-493-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 NE WASCO ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321772",
            "telephone_number": "503-493-8227",
            "fax_number": "503-493-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST RENAL SERVICES, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "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": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PNRS HOLLYWOOD DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PNRS HOLLYWOOD DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.