St. John Dialysis, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

2265 Issued in OK

Legal business name

ST. JOHN DIALYSIS, LLC

Practice address

1923 East 21St Street
Tulsa, OK 74114-1402

Phone

(918) 744-3535

NPI assigned

Nov 2, 2006

Last updated

Feb 12, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

ST. JOHN MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Sr. M. Therese Gottschalk

Title

President/Chief Executive Officer

Phone

(918) 744-2180

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

St Johns Hospital

Member of 1

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

• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368

  Member Of

  NPD member

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1902984156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 EAST 21ST STREET",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741141402",
            "telephone_number": "918-744-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN DIALYSIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOHN MEDICAL CENTER",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "GOTTSCHALK",
        "authorized_official_first_name": "SR. M. THERESE",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "918-744-2180"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OK",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000370114002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Renee St. Clair, MHR
• Savanah Elizabeth St. Clair
• St. John Anesthesia Services, Inc.
• St. John Ascension
• St. John Dialysis, LLC
• St. John Emergency Services, Inc.
• St. John Home Care LLC (Ascension at Home - Tulsa)
• St. John Home Care LLC
• St. John Medical Center
• St. John Medical Center

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tulsa, OK
• Providers in Tulsa, OK by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.