BONNEVILLE DIALYSIS CENTER (NPI# 1003915513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003915513 |
| Entity Type | Organization |
| Organization Name | BONNEVILLE DIALYSIS CENTER |
| Other Organization Name | UNIVERSITY OF UTAH |
| Practice Address |
5575 S 500 E Ogden UT 84405-6907 |
| Mailing Address |
Po Box 27071 Salt Lake City UT 84127-0071 |
| Practice Telephone | 8014790351 |
| Practice Fax Number | 8014761766 |
| Mailing Telephone | 8015818578 |
| Mailing Fax Number | 8014761766 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-09-11 |
| Authorized Official Name | MR. STEVEN L HEMMING (PROGRAM ADMINISTRATOR) |
| Authorized Official Telephone | 8015818573 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
2004-ESRD-389 | UT | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| University of Utah | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851455224 | Bonneville Dialysis Center | Internal Medicine | 5575 S 500 E, Ogden, UT 84405-6907 | 2006-12-20 |
| Street Address |
5575 S 500 E |
| City | OGDEN |
| State | UT |
| Zip Code | 84405-6907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003245374 | Edith Delapp | Dietitian, Registered | 5575 S 500 E, Ogden, UT 84405-6907 | 2013-11-06 |
| 1114106275 | Jill L Neilson | Dietitian, Registered | 5575 S 500 E, Ogden, UT 84405-6907 | 2007-10-25 |
| 1851455224 | Bonneville Dialysis Center | Internal Medicine | 5575 S 500 E, Ogden, UT 84405-6907 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669028171 | Alyssa House | Behavioral Analyst | 4933 1500 West #110, Riverdale, UT 84405 | 2019-08-12 |
| 1518525989 | Petersen Farms Assisted Living & Memory Care | Assisted Living Facility | 6980 S. 475 E., South Weber, UT 84405 | 2019-05-31 |
| 1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
| 1194218461 | South Weber City | Ambulance | 7365 S 1375 E, South Weber, UT 84405 | 2018-06-12 |
| 1528572682 | Sandra Jo Scott | Dental Hygienist | 264 W Ridgeline Dr, Washington Terrace, UT 84405 | 2017-11-28 |
| 1376079061 | Loretta Shupe | Registered Nurse | 5319 S 500 E, Ogden, UT 84405 | 2017-05-02 |
| 1134661374 | Randy Ferrin | Registered Nurse | 5697 Maplewood Drive, South Ogden, UT 84405 | 2016-11-04 |
| 1871046284 | Karla Rosen | Counselor | 5202 S. Freeway Park Dr., Riverdale, UT 84405 | 2016-08-02 |
| 1053784520 | Jenifer Rebecca Nilson Smith | Physical Therapist | 5648 S. Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| 1972976454 | Jenniferlyn Fletcher | Physical Therapy Assistant | 5648 South Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| Find all providers in zip 84405 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013144872 | University of Utah Dialysis Program | Clinic/Center | 1151 East Country Hills Drive, Ogden, UT 84403 | 2009-06-18 |
| 1225224066 | Liberty Dialysis - Weber County LLC | Clinic/Center | 4780 Old Post Rd, Ogden, UT 84403-4454 | 2007-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587571 | Bmh Kidney Care LLC | Clinic/Center | 802 S 200 W Ste B, Blanding, UT 84511-3910 | 2020-10-29 |
| 1053956391 | Hegan Dialysis, LLC | Clinic/Center | 490 S State St, Orem, UT 84058-6302 | 2019-11-11 |
| 1811554124 | Pomme Dialysis, LLC | Clinic/Center | 1250 W Sandalwood Dr, Lehi, UT 84043-4615 | 2019-05-22 |
| 1992223556 | Wakonda Dialysis LLC | Clinic/Center | 555 W State Road 164 Ste 101, Salem, UT 84653-5732 | 2017-09-05 |
| 1831627223 | Fresenius Medical Care Provo, LLC | Clinic/Center | 135 South Orem Blvd, Ste 101, Orem, UT 84058-3006 | 2017-05-30 |
| 1407394463 | Fresenius Medical Care Pleasant View, LLC | Clinic/Center | 1735 West 2700 North, Farr West, UT 84404-1208 | 2017-02-09 |
| 1356897961 | Fresenius Medical Care Utah, LLC | Clinic/Center | 4101 W Pioneer Pkwy, Suite 101, West Valley City, UT 84120-2050 | 2016-09-01 |
| 1770951030 | Liberty Dialysis-weber County, LLC | Clinic/Center | 475 East 40th St, Suite 110, South Ogden, UT 84403-1852 | 2015-09-03 |
| 1558746727 | Fresenius Medical Care Riverton, LLC | Clinic/Center | 12523 South Meadow Creek Drive, Riverton, UT 84065-7259 | 2015-07-29 |
| 1093199135 | Fresenius Medical Care Cedar City, LLC | Clinic/Center | 1320 North Main Street, Cedar City, UT 84721 | 2015-07-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.