Tillamook Kidney Center LLC

Primary specialty

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

Legal business name

TILLAMOOK KIDNEY CENTER LLC

Practice address

1000 3Rd St
Tillamook, OR 97141-3430

Phone

(816) 509-8559

Fax

(816) 241-4468

NPI assigned

Oct 2, 2024

Last updated

Oct 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donovan Schultz

Title

President

Phone

(615) 327-3061

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Tillamook Kidney CenterCCN 382593

Ownership

Non-profit

Certified

Jul 9, 2025

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Dialysis Clinic, Inc.

Dialysis stations

7

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

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

• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Nashville, TN
  • NPI 1871526350

  Member Of

  NPD member

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Nicole M Kemper, MD

  • Nephrology Physician
  • Portland, OR
  • NPI 1326251828

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1952129470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 CHURCH ST STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032948",
            "telephone_number": "615-327-3061",
            "fax_number": "615-963-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 3RD ST",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413430",
            "telephone_number": "816-509-8559",
            "fax_number": "816-241-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILLAMOOK KIDNEY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tillamook County Transportation District
• Tillamook Denture Clinic
• Tillamook Dialysis Center, LLC (U.S. Renal Care Tillamook Dialysis)
• Tillamook Family Counseling Center
• Tillamook Family Counseling Center
• Tillamook Medical Associates Lab
• Tillamook Medical Associates PC
• Tillamook Optometric Clinic
• Tillamook Specialist Associates, LLC
• Tillamook Speech Language Learning Center

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tillamook, OR
• Providers in Tillamook, OR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.