Organization Active NPI

Total Renal Care Inc

Doing business as Gate City Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pocatello, ID
National Provider Identifier
1497707020
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TOTAL RENAL CARE INC
Doing business as
Gate City Dialysis Center
Practice address
2001 Bench Rd
Pocatello, ID 83201
Phone
(208) 637-1090
Fax
(208) 637-1097
NPI assigned
May 16, 2006
Last updated
Aug 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Authorized official

Name
James K Hilger
Title
Chief Accounting Officer
Phone
(253) 733-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

2001 Bench Rd
Pocatello, ID 83201

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 341-6814

Other identifiers 1

IdentifierTypeStateIssuer
807605900MedicaidID

Other names 1

  • Gate City Dialysis Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1497707020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-341-6814",
            "fax_number": "800-293-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BENCH RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-637-1090",
            "fax_number": "208-637-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4500"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807605900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gate City Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gate City Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.