Total Renal Care, Inc.

Primary specialty

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

Legal business name

TOTAL RENAL CARE, INC.

Practice address

1165 Summers Dr
Rexburg, ID 83440-5224

Phone

(208) 516-3868

Fax

(208) 516-3878

NPI assigned

Oct 21, 2021

Organization subpart

No

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

Authorized official

Name

Sam T Wey

Title

Sr Director Licensure/Certification

Phone

(615) 341-6691

Specialties & licenses 1

Addresses

Other names 1

• Yellowstone Dialysis Doing business as

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1346903770",
    "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",
            "telephone_number": "615-341-6814",
            "fax_number": "800-293-8405"
        },
        {
            "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": "208-516-3868",
            "fax_number": "208-516-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SR DIRECTOR LICENSURE/CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6691"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yellowstone Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Yellowstone Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaren M Thueson, DDS
• Karissa Thueson, NNP
• Ashley Tippetts
• Bethany Tlustek
• Travis Roy Torngren, MD
• Brandon S Tracy, FNP-C
• Trevor Rasmussen Counseling LLC
• Rikki Trussel, PHARM D
• Peytan Alexa Crapo Tucker, LMSW
• Tueller Counseling Inc

• All providers in Rexburg, ID
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.