Organization Active NPI

Fresenius Medical Care Bridgeton, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bridgeton, NJ
National Provider Identifier
1962064758
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
FRESENIUS MEDICAL CARE BRIDGETON, LLC
Practice address
12 Cornwell Dr
Bridgeton, NJ 08302-3633
Phone
(856) 453-4464
Fax
(856) 453-4467
NPI assigned
Jul 2, 2019
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

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

Addresses

Primary practice location

12 Cornwell Dr
Bridgeton, NJ 08302-3633

Mailing address

12 Cornwell Dr
Bridgeton, NJ 08302-3633
Phone (856) 453-4464

Other names 1

  • FRESENIUS KIDNEY CARE BRIDGETON Doing business as

National Provider Directory

National Provider Directory

Member of 2

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

Locations

12 Cornwell Dr
Bridgeton, NJ 08302
Phone (856) 453-4464

32 Cornwell Dr
Bridgeton, NJ 08302

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1962064758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CORNWELL DR",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083023633",
            "telephone_number": "856-453-4464",
            "fax_number": "856-453-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CORNWELL DR",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083023633",
            "telephone_number": "856-453-4464",
            "fax_number": "856-453-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE BRIDGETON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2019-07-02",
        "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 BRIDGETON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FRESENIUS KIDNEY CARE BRIDGETON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeton, NJ

Sources for this page

  • 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.