Organization Active NPI

Renal Care Consultants PC

Doing business as Redwood Dialysis Services

  • Renal Dialysis Technician
  • Medford, OR
National Provider Identifier
1417948340
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Dialysis TechnicianTaxonomy code 2472R0900X
Legal business name
RENAL CARE CONSULTANTS PC
Doing business as
Redwood Dialysis Services
Practice address
2868 Creekside Cir
Medford, OR 97504-8442
Phone
(541) 776-4805
Fax
(541) 773-6016
NPI assigned
Oct 31, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karen McEwen, RN
Title
Administrator
Phone
(541) 776-4805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Dialysis Technician 2472R0900X NU Primary

Addresses

Primary practice location

2868 Creekside Cir
Medford, OR 97504-8442

Mailing address

201 SW L St
Grants Pass, OR 97526-2913
Phone (541) 474-0776

Other identifiers 2

IdentifierTypeStateIssuer
XCDC00694OtherCAMEDI CAL
208391MedicaidOR

Other names 1

  • Redwood Dialysis Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040726000436 OR Part B Supplier - Clinic/Group Practice 9830179134 Receives reassigned benefits from 15 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Medford, OR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

201 SW L St
Grants Pass, OR 97526
Phone (541) 474-0776

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417948340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SW L ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262913",
            "telephone_number": "541-474-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2868 CREEKSIDE CIR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048442",
            "telephone_number": "541-776-4805",
            "fax_number": "541-773-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL CARE CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCEWEN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-776-4805",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "2472R0900X",
            "taxonomy_group": "",
            "desc": "Technician, Other, Renal Dialysis",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "XCDC00694",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208391",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redwood Dialysis Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.