NPIMap

Fresenius Medical Care of O'Fallon

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · O Fallon, MO

NPI 1972522142 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1972522142
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
FRESENIUS MEDICAL CARE OF O'FALLON
Practice address
4663 Highway K
O Fallon, MO 63368-8690
Phone
(636) 300-4036
Fax
(636) 300-4065
NPI assigned
Jul 19, 2006
Organization subpart
No

Authorized official

Name
Mrs. Rose Lynn Mattli, R.N.
Title
Clinical Manager
Phone
(636) 300-4036

Corporate family (same tax ID) 18

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

National Provider Directory

Tax ID family
Quality Care Dialysis N (19 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

4663 Highway K
O Fallon, MO 63368-8690

Mailing address

4663 Highway K
O Fallon, MO 63368-8690
Phone (636) 300-4036

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972522142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4663 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688690",
            "telephone_number": "636-300-4036",
            "fax_number": "636-300-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4663 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688690",
            "telephone_number": "636-300-4036",
            "fax_number": "636-300-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE OF O'FALLON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTLI",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "636-300-4036",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

All providers in O Fallon, MO · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missouri

Sources for this page

Verify at the official NPI Registry.