NPIMap

Organization Active NPI

Renal Dimensions, LLC

Doing business as Renal Care Group-Southeast Valley

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Queen Creek, AZ
National Provider Identifier
1821171026
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RENAL DIMENSIONS, LLC
Doing business as
Renal Care Group-Southeast Valley
Practice address
22715 S Ellsworth Rd
Building D
Queen Creek, AZ 85242-6119
Phone
(480) 677-2463
NPI assigned
Oct 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark Fawcett
Title
Treasurer
Phone
(781) 402-9000

Specialties & licenses 1

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

Addresses

Primary practice location

22715 S Ellsworth Rd
Building D
Queen Creek, AZ 85242-6119

Mailing address

22715 S Ellsworth Rd
Building D
Queen Creek, AZ 85242-6119
Phone (480) 677-2463

Other names 1

  • Renal Care Group-Southeast Valley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

22715 S Ellsworth Rd
Ste D
Queen Creek, AZ 85142
Phone (480) 677-2463

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821171026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22715 S ELLSWORTH RD",
            "address_2": "BUILDING D",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852426119",
            "telephone_number": "480-677-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22715 S ELLSWORTH RD",
            "address_2": "BUILDING D",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852426119",
            "telephone_number": "480-677-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL DIMENSIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-402-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renal Care Group-Southeast Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.