Active NPI
Fresenius Medical Care East Peoria Home, LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- East Peoria, IL
National Provider Identifier
1467016709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- FRESENIUS MEDICAL CARE EAST PEORIA HOME, LLC
- Practice address
- 415 Richland St
East Peoria, IL 61611-2476 - Phone
- (309) 698-7245
- Fax
- (309) 698-8030
- NPI assigned
- Apr 23, 2019
- Organization subpart
- Yes
- Parent organization
- FRESENIUS MEDICAL CARE HOLDINGS, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Denise Wright
- Title
- Vice President
- Phone
- (781) 676-5200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
415 Richland St
East Peoria, IL 61611-2476
Mailing address
415 Richland St
East Peoria, IL 61611-2476
Phone (309) 698-7245
Other names 1
- FRESENIUS KIDNEY CARE EAST PEORIA HOME
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190528001467 | IL | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 5991048332 | Practice locations: East Peoria, IL |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- FKC - East Peoria Home
- Overall star rating
- Ownership
- Profit
- Certified
- Aug 8, 2019
- Medicare certification status
- Active
- Chain
- Fresenius Medical Care
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2162090 | Fresenius Kidney Care - East Peoria Home | Certificate of waiver | Feb 14, 2027 |
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Naperville, IL
- NPI 1770593808
Member Of
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Bristol, TN
- NPI 1477570117
Member Of
Locations
424 Richland St
East Peoria, IL 61611
415 Richland St
East Peoria, IL 61611
Phone (309) 698-7245
Practitioners & affiliated clinicians
Affiliated clinicians 9
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788220800000",
"number": "1467016709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 RICHLAND ST",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616112476",
"telephone_number": "309-698-7245",
"fax_number": "309-698-8030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 RICHLAND ST",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616112476",
"telephone_number": "309-698-7245",
"fax_number": "309-698-8030"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRESENIUS MEDICAL CARE EAST PEORIA HOME, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
"enumeration_date": "2019-04-23",
"last_updated": "2026-09-01",
"certification_date": "2026-09-01",
"status": "A",
"authorized_official_last_name": "WRIGHT",
"authorized_official_first_name": "DENISE",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "781-676-5200"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC / Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "FRESENIUS KIDNEY CARE EAST PEORIA HOME",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in East Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.