BONNEVILLE DIALYSIS CENTER (NPI# 1851455224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851455224 |
| Entity Type | Organization |
| Organization Name | BONNEVILLE DIALYSIS CENTER |
| 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 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | STEVE SUTCH (CLINICAL ADMIN. MANAGER) |
| Authorized Official Telephone | 8015877606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| X | 246ZN0300X |
Specialist/Technologist, Other Specialization: Nephrology |
Technologists, Technicians & Other Technical Service Providers | ||
| X | 2472R0900X |
Technician, Other Specialization: Renal Dialysis |
Technologists, Technicians & Other Technical Service Providers | ||
| X | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| X | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003915513 | Bonneville Dialysis Center | Clinic/Center | 5575 S 500 E, Ogden, UT 84405-6907 | 2006-09-21 |
| Street Address |
5575 S 500 E |
| City | OGDEN |
| State | UT |
| Zip Code | 84405-6907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003915513 | Bonneville Dialysis Center | Clinic/Center | 5575 S 500 E, Ogden, UT 84405-6907 | 2006-09-21 |
| 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 |
| 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 | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013520154 | Utah Kidney Clinic LLC | Internal Medicine | 4345 Harrison Blvd Ste 101, Ogden, UT 84403-3103 | 2020-08-28 |
| 1225040231 | Northern Utah Nephrology, LLC | Internal Medicine | 425 E 5350 S, Suite 320, Ogden, UT 84405-6946 | 2006-08-12 |
| 1164424750 | Adhish K Agarwal | Internal Medicine | 4403 Harrison Blvd, Suite 2635, Ogden, UT 84403-3244 | 2005-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134588957 | St George Kidney Care LLC | Internal Medicine | 624 S 1000 E Ste 103, St George, UT 84790-5902 | 2016-02-22 |
| 1952560351 | Aylin Rachel Rodan | Internal Medicine | 85 Medical Dr, Room 223, Salt Lake City, UT 84112-1100 | 2008-06-02 |
| 1467644286 | Kristie Elizabeth Jones | Internal Medicine | 5315 Adams Ave Pkwy Ste A, South Ogden, UT 84405-4772 | 2007-08-15 |
| 1578761003 | Hasan Joseph Salameh | Internal Medicine | 650 E 4500 S Ste 210, Salt Lake City, UT 84107-4520 | 2007-07-05 |
| 1801807144 | Jerald P Boseman | Internal Medicine | 121 S Orem Blvd Ste 103, Orem, UT 84058 | 2006-08-11 |
| 1801824438 | Sey M Lau | Internal Medicine | 3702 S State St Ste 107, Salt Lake City, UT 84115-5096 | 2006-06-30 |
| 1124064845 | Terry C Hammond | Internal Medicine | 1175 E 50 S Ste 161, American Fork, UT 84003-2845 | 2006-06-21 |
| 1679533012 | Nephrology Medical Associates of Georgia LLC | Internal Medicine | 880 E 3900 S, Ste B, Salt Lake City, UT 84107-2151 | 2006-03-27 |
| 1841271491 | Sheetal Shah | Internal Medicine | 3181 W 9000 S, West Jordan, UT 84088-5610 | 2005-11-10 |
| 1366444051 | Carlos Alberto Mercado | Internal Medicine | 624 S 1000 E, Ste 103, St George, UT 84790-5902 | 2005-08-11 |
| 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.