TRC - FOUR CORNERS DIALYSIS CLINICS LLC (NPI# 1487619326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487619326 |
| Entity Type | Organization |
| Organization Name | TRC - FOUR CORNERS DIALYSIS CLINICS LLC |
| Other Organization Name | SHIPROCK DIALYSIS CENTER |
| Practice Address |
Us Highway 491 North Shiprock NM 87420-2156 |
| Mailing Address |
5200 Virginia Way L&c Department Brentwood TN 37027-7569 |
| Practice Telephone | 5053684125 |
| Practice Fax Number | 5053684235 |
| Mailing Telephone | 6153416814 |
| Mailing Fax Number | 8002938405 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2018-08-02 |
| Authorized Official Name | JIM HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| 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 |
6762 | NM | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 485161 | 05 | |
| CO | 23752734 | 05 | |
| NM | 75514 | 05 |
| Other Name | Type Code |
|---|---|
| Shiprock Dialysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700842432 | Trc - Four Corners Dialysis Clinics LLC | Clinic/Center | Hwy 264, Mile Marker 388, Polacca, AZ 86042-0964 | 2006-04-21 |
| 1184680803 | Trc - Four Corners Dialysis Clinics LLC | Clinic/Center | Us Highway 191, Chinle, AZ 86503 | 2006-04-21 |
| 1063477727 | Trc - Four Corners Dialysis Clinics LLC | Clinic/Center | 801 W Broadway, Farmington, NM 87401-5650 | 2006-04-18 |
| Street Address |
US HIGHWAY 491 NORTH |
| City | SHIPROCK |
| State | NM |
| Zip Code | 87420-2156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790786028 | Camille Marie Ristroph | Family Medicine | Us Highway 491 North, Physician Offices, Shiprock, NM 87420-0160 | 2005-08-09 |
| 1497368567 | Melvina Lake | Pharmacist | Us Highway 491 North, Shiprock, NM 87420 | 2020-08-28 |
| 1982032355 | William Nicholas | Physician Assistant | Us Highway 491 North, Shiprock, NM 87420 | 2013-10-23 |
| 1184903411 | Leslie Meyer | Optometrist | Us Highway 491 North, Shiprock, NM 87420 | 2011-08-04 |
| 1063708774 | Patrick William Murphy | Internal Medicine | Us Highway 491 North, Northern Navajo Medical Center, Shiprock, NM 87420 | 2011-06-21 |
| 1831327204 | Rebecca Sara Adler | Internal Medicine | Us Highway 491 North, Northern Navajo Medical Center, Shiprock, NM 87420-0160 | 2009-06-24 |
| 1235312315 | Dhhs, Phs, Naihs, Shiprock Hospital | Clinic/Center | Us Highway 491 North, Shiprock, NM 87420 | 2007-12-11 |
| 1154504231 | Dhhs, Phs, Naihs, Shiprock Hospital | General Acute Care Hospital | Us Highway 491 North, Shiprock, NM 87420-0160 | 2007-12-11 |
| 1356424006 | Michelle A Williams | Counselor | Us Highway 491 North, Shiprock, NM 87420 | 2006-10-23 |
| 1972615912 | Heather C Kovich | Family Medicine | Us Highway 491 North, Shiprock, NM 87420 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003424383 | Ciara Hansen | Psychologist | Us- 491, Shiprock, NM 87420 | 2020-07-22 |
| 1013540848 | Kelsi Marie Hartwig | Dental Hygienist | Highway 491 North, Yucca Street, Shiprock, NM 87420 | 2020-02-20 |
| 1194364232 | Maria Sturtz | Pharmacist | Us Why 491 North, Shiprock, NM 87420 | 2020-01-06 |
| 1811533979 | Merissa Jo De La Garza | Pharmacist | Highway 491 S, Shiprock, NM 87420 | 2019-11-25 |
| 1619528510 | Heather Scott | Psychologist | Highway 64, Old High School Road, Shiprock, NM 87420 | 2019-09-23 |
| 1396305264 | Malaura Creager | Pharmacist | North Hwy 491, Shiprock, NM 87420 | 2019-06-13 |
| 1275011488 | Dawn Fowler | Registered Nurse | Us Highway 64, Shiprock, NM 87420 | 2018-07-31 |
| 1902384373 | Brittany Jones | Occupational Therapy Assistant | Us 64, Old High School Rd., Shiprock, NM 87420 | 2018-07-30 |
| 1528561701 | Patricia D Suarez | Registered Nurse | Central Consolidated School of New Mexico, Hwy 64, Old High School Road, Shiprock, NM 87420 | 2018-03-14 |
| 1023549284 | Ellen Liversidge | Speech-Language Pathologist | Hwy 64, Old High School Rd., Shiprock, NM 87420 | 2017-03-21 |
| Find all providers in zip 87420 | ||||
| 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 |
|---|---|---|---|---|
| 1447866108 | Bio-medical Applications of New Mexico, Inc. | Clinic/Center | 2050 Knudsen Ave, Ste C, Farmington, NM 87401-9070 | 2020-09-18 |
| 1306499405 | Trc Four Corners Dialysis Clinics LLC | Clinic/Center | 4525 Rowe Ave, Farmington, NM 87402-3013 | 2019-07-18 |
| 1457829269 | Valley Home Dialysis | Clinic/Center | 3900 E Lohman Ave Ste B1, Las Cruces, NM 88011-8268 | 2018-11-09 |
| 1235636283 | Usrc Las Cruces LLC | Clinic/Center | 250 E Amador Ave, Las Cruces, NM 88001-3649 | 2018-04-06 |
| 1124523857 | Bio Medical Applications of New Mexico, Inc. | Clinic/Center | 5221 Las Soleras Dr, Santa Fe, NM 87507-2101 | 2018-03-26 |
| 1710406301 | Dialysis Clinic Inc | Clinic/Center | 8121 Central Ave Nw, Albuquerque, NM 87121-2125 | 2017-09-14 |
| 1033634175 | Chantry Dialysis, LLC | Clinic/Center | 10410 Copper Point Way Ne, Albuquerque, NM 87123-1158 | 2017-08-10 |
| 1124477112 | Home Dialysis of Santa Fe, LLC | Clinic/Center | 2904 Rodeo Park Dr E Ste 300a-1, Santa Fe, NM 87505-6305 | 2016-06-09 |
| 1811358609 | Solid Rock Dialysis, LLC | Clinic/Center | 1580 Highway 264, Suite A, Gallup, NM 87301-3302 | 2016-03-08 |
| 1003274309 | Fresenius Medical Care Sandhill, LLC | Clinic/Center | 1306 Enterprise Rd., Socorro, NM 87801 | 2016-02-02 |
| 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.