Community Medical Center Dialysis

Primary specialty

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

Legal business name

COMMUNITY MEDICAL CENTER DIALYSIS

Practice address

1325 S Reserve St
Missoula, MT 59801-4759

Phone

(406) 728-6585

Fax

(406) 728-6586

NPI assigned

Aug 10, 2018

Organization subpart

No

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

Authorized official

Name

Mr. William E Wood II

Title

President

Phone

(615) 327-3061

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Listed as

Community Medical Center Dialysis LLCCCN 272515

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Apr 10, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Dialysis Clinic, Inc.

Dialysis stations

10

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 2

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

• RCHP Billings - Missoula LLC

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1891164125

  Member Of

  NPD member
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brownsville, TN
  • NPI 1013940493

  Member Of

  NPD member

Locations

Practitioners 1

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

• Kristina Marie Phipps, CCHT, CNA

  • Nephrology Specialist/Technologist
  • Missoula, MT
  • NPI 1922823319
  NPD

Affiliated clinicians 1

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

• Shahid Sattar Chaudhary, M.D.

  • Nephrology Physician
  • Missoula, MT
  • NPI 1902986987

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569456000000",
    "number": "1992284814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 COMMONS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011900",
            "telephone_number": "406-756-5565",
            "fax_number": "406-756-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S RESERVE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014759",
            "telephone_number": "406-728-6585",
            "fax_number": "406-728-6586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2835 Fort Missoula Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "59804",
            "country_code": "US",
            "telephone_number": "406-728-6585",
            "fax_number": "406-728-6586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL CENTER DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2019-09-26",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Care LLC
• Community Medical Center
• Community Medical Center
• Community Medical Center
• Community Medical Center
• Community Medical Center Inc
• Community Medical Center Inc
• Community Medical Center Inc
• Community Medical Center Inc
• Community Medical Center Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missoula, MT
• Providers in Missoula, MT by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.