Lakeside Dialysis Center University of Utah

Primary specialty

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

License

2004-ESRD-932 Issued in UT

Legal business name

LAKESIDE DIALYSIS CENTER UNIVERSITY OF UTAH

Practice address

532 S 500 W
Bountiful, UT 84010-7208

Phone

(801) 299-3470

Fax

(801) 299-3415

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven L. Hemming

Title

Director/Ceo

Phone

(801) 581-3659

Specialties & licenses 1

Addresses

Other names 1

• University of Utah Doing business as

Member of 1

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

• University of Utah

  • Home Infusion Therapy Pharmacy
  • Murray, UT
  • NPI 1306883954

  Member Of

  NPD member

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1508965617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27071",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841277071",
            "telephone_number": "801-299-3470",
            "fax_number": "801-587-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 S 500 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107208",
            "telephone_number": "801-299-3470",
            "fax_number": "801-299-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE DIALYSIS CENTER UNIVERSITY OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "HEMMING",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECTOR/CEO",
        "authorized_official_telephone_number": "801-581-3659",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "UT",
            "license": "2004-ESRD-932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor Marie Krupp, PA-C
• Brooke Kumar, LCSW
• Lauren Parker Kwallek
• L.a.C.E. by Louise, Inc.
• Spencer Lee Lake
• Lakeview Hospital Physician Services LLC
• Lakeview Neurology PC
• Lakeview Neurosurgery Clinic LLC
• Lakeview Neurosurgery Clinic, LLC
• Lakeview Neurosurgery Clinic, LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bountiful, UT
• Providers in Bountiful, 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 Jul 11, 2014; 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.