NPIMap

Organization Active NPI

Northern Sierra Dialysis Center, LLC.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Reno, NV
National Provider Identifier
1770686255
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
3410ESR-4 Issued in NV
Legal business name
NORTHERN SIERRA DIALYSIS CENTER, LLC.
Practice address
10085 Double R Blvd
Ste 160
Reno, NV 89511
Phone
(775) 982-4027
Fax
(775) 982-8104
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Authorized official

Name
Mr. Scott Keith Van Wagner
Title
Executive Director
Phone
(775) 982-4027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 3410ESR-4 NV Primary

Addresses

Primary practice location

10085 Double R Blvd
Ste 160
Reno, NV 89511

Mailing address

1500 E 2ND St Ste 101
Reno, NV 89502-1189
Phone (775) 982-4027

Other names 1

  • Northern Sierra Dialysis Center at South Meadows Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Routt Dialysis LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1770686255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021189",
            "telephone_number": "775-982-4027",
            "fax_number": "775-982-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10085 DOUBLE R BLVD",
            "address_2": "STE 160",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-982-4027",
            "fax_number": "775-982-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN SIERRA DIALYSIS CENTER, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "VAN WAGNER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "775-982-4027",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NV",
            "license": "3410ESR-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Sierra Dialysis Center at South Meadows",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.