Renal Treatment Centers West Inc

Primary specialty

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

Legal business name

RENAL TREATMENT CENTERS WEST INC

Doing business as

Stillwater Dialysis Center

Practice address

406 E Hall of Fame Ave Ste 300
Stillwater, OK 74075-5447

Phone

(405) 707-0408

Fax

(405) 624-6405

NPI assigned

Apr 4, 2006

Last updated

Jun 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Chief Accounting Officer

Phone

(253) 733-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stillwater Dialysis Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336101559. Details of each certification follow.

• CCN 372505 End-stage renal disease facility · Active · Name & address match · Details

End-stage renal disease facility certification: CCN 372505

Legal name

STILLWATER DIALYSIS CENTER

Certification status

Active

Provider type (POS)

End-stage renal disease facility

Participating since

Aug 26, 1983

Last certification

Feb 19, 2019

Ownership / control type

For Profit

Multi-facility organization

DAVITA INC

Facility address

406 East Hall of Fame, Suite 300
Stillwater, OK 74075

Locations (25 of 32)

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ayesha Anwaar

  • Nephrology Physician
  • Tulsa, OK
  • NPI 1487007449
  NPD (past)
• Monica Brownfield, APRN

  • Family Nurse Practitioner
  • Elk City, OK
  • NPI 1295387363
  NPD (past)
• Jamie L Everett

  • Clinical Social Worker
  • Oklahoma City, OK
  • NPI 1508071218
  NPD (past)
• Robert M. Gold, MD

  • Nephrology Physician
  • Tulsa, OK
  • NPI 1710070750
  NPD (past)
• David Collier Williams, M.D.

  • Nephrology Physician
  • Norman, OK
  • NPI 1518991264
  NPD (past)
• Shubha Ananthakrishnan, MD

  • Nephrology Physician
  • Sacramento, CA
  • NPI 1275633869
  NPD (past)
• Mildred Bright

  • Registered Dietitian
  • Seattle, WA
  • NPI 1235315508
  NPD (past)
• Geri Lee Jennings, RD

  • Renal Nutrition Registered Dietitian
  • Yakima, WA
  • NPI 1306805791
  NPD (past)
• Michelle Marchiano, LCSW

  • Social Worker
  • Centennial, CO
  • NPI 1720749526
  NPD (past)
• Abbey Lawren Royer, RN

  • Registered Nurse
  • Hermiston, OR
  • NPI 1922391986
  NPD (past)

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1336101559",
    "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",
            "telephone_number": "615-341-5893",
            "fax_number": "877-850-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E HALL OF FAME AVE STE 300",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740755447",
            "telephone_number": "405-707-0408",
            "fax_number": "405-624-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS WEST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4500"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100733210G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stillwater Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ally Mae Reese
• J. Weston Heath Reese, D.C.
• Henry Duncan Reeves, OD
• Rehabcare Group, Inc.
• Rita Mary Rempe, RN
• Benjamin Rendon
• David T Reynolds, O.D.
• Rhonda Reynolds, RN
• Shelby Reynolds
• Andrea Rice

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Stillwater, OK
• Providers in Stillwater, OK by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.