Active NPI
Sterling Regional Medcenter
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Sterling, CO
National Provider Identifier
1417014697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- STERLING REGIONAL MEDCENTER
- Practice address
- 615 Fairhurst St
Sterling, CO 80751-4523 - Phone
- (970) 522-0122
- NPI assigned
- Jan 3, 2007
- Organization subpart
- Yes
- Parent organization
- BANNER HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dennis Dahlen
- Title
- Sr Vice President Finance
- Phone
- (602) 747-4000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
615 Fairhurst St
Sterling, CO 80751-4523
Mailing address
1441 N 12TH St
Phoenix, AZ 85006-2837
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05258074 | Medicaid | CO |
National Provider Directory
National Provider Directory- Part of
- M E Lee MD
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": "1167782400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1224115200000",
"number": "1417014697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1441 N 12TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 FAIRHURST ST",
"city": "STERLING",
"state": "CO",
"postal_code": "807514523",
"telephone_number": "970-522-0122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STERLING REGIONAL MEDCENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BANNER HEALTH",
"enumeration_date": "2007-01-03",
"last_updated": "2008-10-16",
"status": "A",
"authorized_official_last_name": "DAHLEN",
"authorized_official_first_name": "DENNIS",
"authorized_official_title_or_position": "SR VICE PRESIDENT FINANCE",
"authorized_official_telephone_number": "602-747-4000"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05258074",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sterling, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.