NRA WASHINGTON COUNTY MISSOURI LLC (NPI# 1548227390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548227390 |
| Entity Type | Organization |
| Organization Name | NRA WASHINGTON COUNTY MISSOURI LLC |
| Other Organization Name | FRESENIUS KIDNEY CARE POTOSI |
| Practice Address |
600 Purcell Rd Potosi MO 63664-1455 |
| Practice Telephone | 5734360723 |
| Practice Fax Number | 5734381001 |
| Mailing Telephone | 5734360723 |
| Mailing Fax Number | 5734381001 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | MR. JAMES J DIVITO (VICE PRESIDENT) |
| Authorized Official Telephone | 7816999000 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
N/A | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | CLIA CERT OF WAIVER | 26D1053681 | 01 |
| MO | 506908607 | 05 |
| Other Name | Type Code |
|---|---|
| Fresenius Kidney Care Potosi | Doing Business As Name - Organization |
| Washington County Dialysis Clinic | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 828 E High St, Suite 2, Potosi, MO 636641410 | 5734368085 | 5734368092 |
| Street Address |
600 PURCELL RD |
| City | POTOSI |
| State | MO |
| Zip Code | 63664-1455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013900687 | Charlotte Ann Edelen | Social Worker | 600 Purcell Rd, Suite B, Potosi, MO 63664-1455 | 2005-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083017461 | Carolyn Coyne Maryan | Specialist/Technologist | 400 Mine St., Citadel School, Potosi, MO 63664 | 2014-09-30 |
| 1205073665 | Potosi Chiropractic Life Center | Chiropractor | 502 North Missouri St., Potosi, MO 63664 | 2009-01-07 |
| 1932385952 | Simpelo Medical Clinic, P.C. | Internal Medicine | 108 Frizzell, Suite 6, Potosi, MO 63664 | 2008-01-22 |
| 1760696918 | Brett T Snodgrass | General Practice | 1 Southtowne Dr., Great Mines Health Center, Potosi, MO 63664 | 2007-05-09 |
| 1710032297 | Washington County Handicapped Services Adult Day Health Care | Day Training, Developmentally Disabled Services | 10604 West Highway E, Potosi, MO 63664 | 2007-01-24 |
| 1578629473 | Greenlee Chiropractic Inc. | Chiropractor | Greenlee Chiropractic, 417 East High St, Potosi, MO 63664 | 2006-12-28 |
| 1003981895 | James Daley Robart Jr. | Chiropractor | 912 N Missouri St, Potosi, MO 63664 | 2006-11-21 |
| 1225063407 | Seth Paskon | Internal Medicine | Potosi Medical Clinic, #1 Kwan Plaza, Potosi, MO 63664 | 2006-07-12 |
| 1346295607 | Donna Yates | Nurse Practitioner | 600 Purcell Dr, Suite B, Potosi, MO 63664 | 2006-05-24 |
| 1467424788 | Washington County Memorial Hospital | Clinic/Center | 108 Frizzell Street, Potosi, MO 63664 | 2006-02-02 |
| Find all providers in zip 63664 | ||||
| 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 |
|---|---|---|---|---|
| 1336748110 | Westbrook Dialysis, LLC | Clinic/Center | 140 West Drive, Cape Girardeau, MO 63701 | 2020-10-22 |
| 1902415284 | Fresenius Medical Care Creve Coeur Home Therapies, LLC | Clinic/Center | 450 N New Ballas Rd Ste 170, Creve Coeur, MO 63141-6835 | 2020-07-23 |
| 1730716085 | Fresenius Medical Care Creve Coeur, LLC | Clinic/Center | 450 North New Bassas Road, Suite 180, Creve Coeur, MO 63141-6835 | 2020-03-26 |
| 1285109041 | Branson Kidney Center LLC | Clinic/Center | 17829 Bus 13, Branson West, MO 65737 | 2018-10-09 |
| 1790271864 | Dialysis Clinic Inc | Clinic/Center | 3101 W Broadway Ste 115, Columbia, MO 65203-0496 | 2018-07-02 |
| 1033602990 | Lantell Dialysis LLC | Clinic/Center | 8608 E 63rd St, Kansas City, MO 64133-4725 | 2018-06-14 |
| 1851892731 | Sparda Dialysis LLC | Clinic/Center | 40 Walters Pl, House Springs, MO 63051-1491 | 2018-02-26 |
| 1063923753 | Isd Renal Inc | Clinic/Center | 1702 E 10th St Ste C, Rolla, MO 65401-4600 | 2017-10-20 |
| 1063923977 | Total Renal Care Inc | Clinic/Center | 802 Jules St, St Joseph, MO 64501-1944 | 2017-10-18 |
| 1942710991 | Washington University | Clinic/Center | 272 Mayfair Plaza Shopping Ctr, Florissant, MO 63033-8009 | 2017-10-04 |
| 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.