Organization Active NPI

Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1790749190
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
OTC0725 Issued in AZ
Legal business name
TOTAL RENAL CARE INC
Practice address
1401 N 24TH St
Ste 2
Phoenix, AZ 85008-4638
Phone
(602) 392-0668
Fax
(602) 392-0669
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Thomas O Usilton Jr.
Title
Group Vice President
Phone
(770) 541-7922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X OTC0725 AZ Primary

Addresses

Primary practice location

1401 N 24TH St
Ste 2
Phoenix, AZ 85008-4638

Mailing address

5200 Virginia Way
Ste 400
Brentwood, TN 37027-7569
Phone (615) 320-4435

Other identifiers 2

IdentifierTypeStateIssuer
07983012MedicaidTX
181876MedicaidAZ

Other names 1

  • Papago 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": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1790749190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4435",
            "fax_number": "303-209-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 24TH ST",
            "address_2": "STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084638",
            "telephone_number": "602-392-0668",
            "fax_number": "602-392-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "USILTON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "GROUP VICE PRESIDENT",
        "authorized_official_telephone_number": "770-541-7922",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AZ",
            "license": "OTC0725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07983012",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181876",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Papago Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.