Qualicenters Pueblo, LLC

Primary specialty

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

Legal business name

QUALICENTERS PUEBLO, LLC

Doing business as

Fresenius Medical Care Canon City Dialysis

Practice address

2245 Fremont Dr
Canon City, CO 81212-2533

Phone

(719) 276-8404

Fax

(719) 276-0015

NPI assigned

Aug 31, 2006

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

Barry L. Blanton

Title

Vice President

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• FRESENIUS MEDICAL CARE CANON CITY DIALYSIS Doing business as

Electronic endpoints 1

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

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1720190523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 FREMONT DR",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122533",
            "telephone_number": "719-276-8404",
            "fax_number": "719-276-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 FREMONT DR",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122533",
            "telephone_number": "719-276-8404",
            "fax_number": "719-276-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALICENTERS PUEBLO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "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.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FRESENIUS MEDICAL CARE CANON CITY DIALYSIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pueblo Radiological Group, P.C.
• Pueblo Radiological Group, P.C.
• Pueblo Radiological Group, P.C.
• Gerald Roman Putzer, CRNA
• Steven Quakenbush, PA
• Margaret Anne Rabel, DMD
• Tracey Rafuse, FNP-C
• Ryan S Rahman, M.D.
• Marc-Andre Rameau
• Danielle Rene Ramseier, LPCC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Canon City, CO
• Providers in Canon City, CO by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.