NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Farmington Bay Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Layton, UT
National Provider Identifier
1336802297
Registry record updated Sep 24, 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
Farmington Bay Dialysis
Practice address
942 S Main St
Layton, UT 84041-4250
Phone
(385) 557-7075
Fax
(385) 557-7089
NPI assigned
Oct 18, 2021
Last updated
Sep 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 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 NU Primary

Addresses

Primary practice location

942 S Main St
Layton, UT 84041-4250

Mailing address

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

Other names 1

  • Farmington Bay Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211125000021 UT Part A Provider - End-Stage Renal Disease Facility (ESRD) 0749473072 Practice locations: Layton, UT

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

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

View all 15

Locations

942 S Main St
Layton, UT 84041
Phone (385) 557-7075

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1336802297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 S MAIN ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414250",
            "telephone_number": "385-557-7075",
            "fax_number": "385-557-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farmington Bay Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Farmington Bay Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.