NPIMap

Organization Active NPI

Yellowstone Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rexburg, ID
National Provider Identifier
1316046444
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
IDAHO DOESNT ISSUE Issued in ID
Legal business name
YELLOWSTONE DIALYSIS CENTER
Doing business as
University of Utah
Practice address
1165 Summers Dr
Rexburg, ID 83440-5224
Phone
(208) 656-0378
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Authorized official

Name
Mr. Steven L Hemming
Title
Program Administrator
Phone
(801) 581-8573

Specialties & licenses 1

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

Addresses

Primary practice location

1165 Summers Dr
Rexburg, ID 83440-5224

Mailing address

PO Box 27071
Salt Lake City, UT 84127-0071
Phone (801) 581-8578

Other names 1

  • University of Utah Doing business as

National Provider Directory

National Provider Directory

Member of 1

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": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1316046444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27071",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270071",
            "telephone_number": "801-581-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 SUMMERS DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405224",
            "telephone_number": "208-656-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YELLOWSTONE DIALYSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "HEMMING",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "801-581-8573",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "ID",
            "license": "IDAHO DOESNT ISSUE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.