NPIMap

Organization Active NPI

Fresno Community Hospital and Medical Center

Doing business as Community Dialysis Center - Fresno

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fresno, CA
National Provider Identifier
1821179656
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
040000096 Issued in CA
Legal business name
FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Doing business as
Community Dialysis Center - Fresno
Practice address
215 N Fresno St
Suite 150
Fresno, CA 93701-2304
Phone
(559) 459-3901
Fax
(559) 459-2579
NPI assigned
Oct 18, 2006
Last updated
Aug 22, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Authorized official

Name
Craig Allen Wagoner
Title
Ceo
Phone
(559) 324-4266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 040000096 CA Primary

Addresses

Primary practice location

215 N Fresno St
Suite 150
Fresno, CA 93701-2304

Mailing address

215 N Fresno St
Suite 150
Fresno, CA 93701-2304
Phone (559) 459-3901

Other names 1

  • Community Dialysis Center - Fresno Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021002000005 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 3173430865 Practice locations: Fresno, CA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Clovis Community Hospit22 organizations share this tax ID, including this one
Part of
Clovis Community Hospit

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1821179656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N FRESNO ST",
            "address_2": "SUITE 150",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012304",
            "telephone_number": "559-459-3901",
            "fax_number": "559-459-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N FRESNO ST",
            "address_2": "SUITE 150",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012304",
            "telephone_number": "559-459-3901",
            "fax_number": "559-459-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY REGIONAL MEDICAL CENTER",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGONER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-324-4266"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "040000096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Dialysis Center - Fresno",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Dialysis Center - Fresno",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.