Bio-Medical Applications of Arizona, LLC

Primary specialty

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

Legal business name

BIO-MEDICAL APPLICATIONS OF ARIZONA, LLC

Doing business as

FMC Dialysis Services Yavapai

Practice address

3605 Ranch Dr
Prescott, AZ 86303-6729

Phone

(928) 443-9626

Fax

(928) 443-9629

NPI assigned

Aug 31, 2006

Last updated

Oct 17, 2023By 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

• FMC DIALYSIS SERVICES YAVAPAI Doing business as

Electronic endpoints 1

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1275645079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 RANCH DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863036729",
            "telephone_number": "928-443-9626",
            "fax_number": "928-443-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 RANCH DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863036729",
            "telephone_number": "928-443-9626",
            "fax_number": "928-443-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIO-MEDICAL APPLICATIONS OF ARIZONA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "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": "FMC DIALYSIS SERVICES YAVAPAI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Debora L. Black, LAC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Prescott, AZ
• Providers in Prescott, AZ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arizona

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