WEST BOUNTIFUL DIALYSIS – NPI #1629032610
Clinic/Center

WEST BOUNTIFUL DIALYSIS is an AHC clinic located in WEST BOUNTIFUL, UT. NPPES has assigned the NPI number 1629032610 to WEST BOUNTIFUL DIALYSIS on April 14, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WEST BOUNTIFUL DIALYSIS” is a dba name, the actual legal business name for this organization is TOTAL RENAL CARE INC. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 6 years ago on Jul 15, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WEST BOUNTIFUL DIALYSIS below.

NPI Profile for
TOTAL RENAL CARE INC

NPI Number
1629032610
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
TOTAL RENAL CARE INC
Doing Business As (dba): WEST BOUNTIFUL DIALYSIS
Primary location
724 W 500 S
STE 300
WEST BOUNTIFUL, UT 84087
Phone: (801) 296-9091 Fax: (801) 296-9094
Mailing address
5200 VIRGINIA WAY
L&C DEPT
BRENTWOOD, TN 37027-7569
Phone: (615) 341-6814 Fax: (800) 293-8405
Organization Subpart
No
Authorized Official
JOHN WINSTEL
CHIEF ACCOUNTING OFFICER
Phone: (253) 733-4501
Updated
Certification Date
Jul 15, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for WEST BOUNTIFUL DIALYSIS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDUT870570546015
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)
UT 2017-ESRD-928

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.