Deseret Peak Dialysis

Primary specialty

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

Legal business name

DESERET PEAK DIALYSIS

Practice address

3333 S 900 E
Ste 130
Salt Lake City, UT 84106-2087

Phone

(801) 930-0131

Fax

(801) 928-5454

NPI assigned

Sep 29, 2015

Organization subpart

No

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

Authorized official

Name

Ryan Gene Kidman

Title

Partner

Phone

(801) 930-0131

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1447620836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S 900 E",
            "address_2": "STE 130",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062087",
            "telephone_number": "801-930-0131",
            "fax_number": "801-928-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S 900 E",
            "address_2": "STE 130",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062087",
            "telephone_number": "801-930-0131",
            "fax_number": "801-928-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERET PEAK DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-29",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "KIDMAN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "801-930-0131"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Deschenes, MSWI
• Deseret Care Center LLC
• Deseret Care LLC (Love Hospice)
• Deseret Health and Rehab at Federal Heights LLC
• Deseret Medical Inc
• Rosemary Ann Deshazo, M.D.
• Cameron Michael Deshetler
• Megan Desimon
• Taylor B. Desmarais, MD, MS
• Sally Joye Desonia, PA-C

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; 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.