NPIMap

Organization Active NPI

Pacific Northwest Renal Services, L.L.C.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
National Provider Identifier
1891807798
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
PACIFIC NORTHWEST RENAL SERVICES, L.L.C.
Practice address
4905 NE Martin Luther King Blvd.
Portland, OR 97211-0000
Phone
(503) 288-7020
Fax
(503) 288-7028
NPI assigned
Aug 31, 2006
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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) 699-9000

Specialties & licenses 1

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

Addresses

Primary practice location

4905 NE Martin Luther King Blvd.
Portland, OR 97211-0000

Mailing address

4905 NE Martin Luther King Blvd.
Portland, OR 97211-0000
Phone (503) 288-7020

Other names 1

  • : PNRS ROSE QUARTER DIALYSIS CENTER Doing business as

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Fresenius Kidney Care Rose QuarterCCN 382522
Overall star rating
1.0 of 5
Ownership
Profit
Certified
Jun 20, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Fresenius Medical Care
Dialysis stations
25

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 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1891807798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 NE MARTIN LUTHER KING BLVD.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972110000",
            "telephone_number": "503-288-7020",
            "fax_number": "503-288-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 NE MARTIN LUTHER KING BLVD.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972110000",
            "telephone_number": "503-288-7020",
            "fax_number": "503-288-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST RENAL SERVICES, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": ": PNRS ROSE QUARTER DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.