NPIMap

Organization Active NPI

Rai Care Centers of Southern California I, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fountain Valley, CA
National Provider Identifier
1821161597
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RAI CARE CENTERS OF SOUTHERN CALIFORNIA I, LLC
Practice address
17197 Newhope St
Suite a-D
Fountain Valley, CA 92708-4228
Phone
(714) 241-0196
Fax
(714) 241-1562
NPI assigned
Nov 17, 2006
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Authorized official

Name
Mr. Mark R. Fawcett
Title
Treasurer
Phone
(781) 699-9000

Specialties & licenses 1

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

Addresses

Primary practice location

17197 Newhope St
Suite a-D
Fountain Valley, CA 92708-4228

Mailing address

17197 Newhope St
Suite a-D
Fountain Valley, CA 37067-4228
Phone (714) 241-0196

Other identifiers 3

IdentifierTypeStateIssuer
052798OtherCABLUE CROSS OF CALIFORNIA
CDC02798GMedicaidCA
ZZZR0212ZOtherCABLUE SHIELD OF CALIFORNIA

Other names 1

  • RAI-Newhope-Fountain Valley Other name

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Rai - New Hope - Fountain ValleyCCN 052798
Overall star rating
3.0 of 5
Ownership
Profit
Certified
May 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Fresenius Medical Care
Dialysis stations
24

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory

Member of 1

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

Locations

17197 Newhope St
Ste Ad
Fountain Valley, CA 92708
Phone (714) 241-0196

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1821161597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17197 NEWHOPE ST",
            "address_2": "SUITE A-D",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "370674228",
            "telephone_number": "714-241-0196",
            "fax_number": "714-241-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17197 NEWHOPE ST",
            "address_2": "SUITE A-D",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084228",
            "telephone_number": "714-241-0196",
            "fax_number": "714-241-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAI CARE CENTERS OF SOUTHERN CALIFORNIA I, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-11-17",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-699-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF CALIFORNIA",
            "identifier": "052798",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02798G",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZR0212Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAI-Newhope-Fountain Valley",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.