Idaho Kidney Center-Blackfoot LLC

Primary specialty

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

Legal business name

IDAHO KIDNEY CENTER-BLACKFOOT LLC

Doing business as

Idaho Kidney Center-Blackfoot

Practice address

245 Poplar St
Blackfoot, ID 83221-4907

Phone

(208) 643-0876

Fax

(208) 643-0859

NPI assigned

Jun 29, 2006

Last updated

Sep 1, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Addresses

Other names 1

• IDAHO KIDNEY CENTER-BLACKFOOT Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Listed as

Idaho Kidney Center - BlackfootCCN 132515

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Nov 20, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Fresenius Medical Care

Dialysis stations

13

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

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

• National Medical Care, Inc.

  dba RCC Sebring

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sebring, FL
  • NPI 1477665214

  Member Of

  NPD member

Locations

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Hira Siktel, MD

  • Internal Medicine Physician
  • Chubbuck, ID
  • NPI 1477790962

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1467480582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832214907",
            "telephone_number": "208-643-0876",
            "fax_number": "208-643-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832214907",
            "telephone_number": "208-643-0876",
            "fax_number": "208-643-0859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "98 Poplar St",
            "address_purpose": "LOCATION",
            "city": "Blackfoot",
            "state": "ID",
            "postal_code": "832211758",
            "country_code": "US",
            "telephone_number": "206-236-5001",
            "fax_number": "206-236-5002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IDAHO KIDNEY CENTER-BLACKFOOT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-06-29",
        "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": "IDAHO KIDNEY CENTER-BLACKFOOT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tresa Hyde, MSW, LCSW
• Idaho Dept of Health & Welfare Reg 6 CMH BF C
• Idaho Dept of Health & Welfare Reg 7 Amh BF
• Idaho Dept of Health & Welfare Reg 7 CMH P C
• Idaho Express Transportation LLC
• Idaho Pathology Laboratory
• Idaho Physicians Clinic
• Idaho Science & Technology Charter School
• Harrison Jacob Inskeep
• Intercept Systems, PLLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• 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 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.

Verify at the official NPI Registry.