Fresenius Medical Care Ottumwa, LLC

Primary specialty

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

Legal business name

FRESENIUS MEDICAL CARE OTTUMWA, LLC

Doing business as

Fresenius Kidney Care Black Hawk Home

Practice address

1655 E San Marnan Dr Ste E
Waterloo, IA 50702-4380

Phone

(319) 595-2050

Fax

(319) 242-3556

NPI assigned

Sep 30, 2020

Last updated

Sep 1, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Barry L. Blanton

Title

Vice President

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• FRESENIUS KIDNEY CARE BLACK HAWK HOME Doing business as

Tax ID family

Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fresenius Medical Care Ottumwa, LLC

  dba Fresenius Medical Care Ottumwa

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ottumwa, IA
  • NPI 1639634207
  NPD tax ID

Member of 1

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

• National Medical Care, Inc.

  dba Renal Care Center (RCC) of Johnson City

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Johnson City, TN
  • NPI 1215049044

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1942817218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 E SAN MARNAN DR STE E",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507024380",
            "telephone_number": "319-595-2050",
            "fax_number": "319-242-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 E SAN MARNAN DR STE E",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507024380",
            "telephone_number": "319-595-2050",
            "fax_number": "319-242-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE OTTUMWA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2020-09-30",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "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": "FRESENIUS KIDNEY CARE BLACK HAWK HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abby Freese, FNP-BC
• Elizabeth Freese
• Michael Paul Freeseman, DDS MS
• Jason Freiberg, PHARM D.
• Ella Frere
• Ericka Frey
• Michele L. Friedman, A.R.N.P.
• Robert L Friedman, M.D.
• Thomas G Friedman, DDS
• Friends at Home

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Waterloo, IA
• Providers in Waterloo, IA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.