DVA HEALTHCARE RENAL CARE INC (NPI# 1073581203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073581203 |
| Entity Type | Organization |
| Organization Name | DVA HEALTHCARE RENAL CARE INC |
| Other Organization Name | ATLANTA AIRPORT DIALYSIS |
| Practice Address |
2685 Metropolitan Pkwy Sw Ste F Atlanta GA 30315-7926 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 4047612630 |
| Practice Fax Number | 4047612618 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-06-22 |
| Authorized Official Name | JOHN WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| 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 |
ESRD001023 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000440074A | 05 | |
| DC | 035641900 | 05 |
| Other Name | Type Code |
|---|---|
| Atlanta Airport Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831690098 | Dva Healthcare Renal Care Inc | Clinic/Center | 3901 N Roxboro St Ste 108, Durham, NC 27704-2181 | 2018-02-23 |
| 1639695984 | Dva Healthcare Renal Care Inc | Clinic/Center | 209 Nc Highway 111 S, Goldsboro, NC 27534-9253 | 2017-08-18 |
| 1710351531 | Dva Healthcare Renal Care Inc | Clinic/Center | 101 Davita Ln, Elizabeth City, NC 27909-3314 | 2015-11-17 |
| 1851769848 | Dva Healthcare Renal Care Inc | Clinic/Center | 9622 Kincey Ave, Huntersville, NC 28078-9140 | 2015-09-08 |
| 1447643408 | Dva Healthcare Renal Care Inc | Clinic/Center | 1274 Ruin Creek Road, Henderson, NC 27537-4168 | 2015-03-13 |
| 1205116167 | Dva Healthcare Renal Care Inc | Clinic/Center | 11308 Hawthorne Dr, Mint Hill, NC 28227-9300 | 2011-08-24 |
| 1932363744 | Dva Healthcare Renal Care Inc | Clinic/Center | 7260 E Marshville Blvd, Marshville, NC 28103-1191 | 2008-07-11 |
| 1689868739 | Dva Healthcare Renal Care Inc | Clinic/Center | 6620 Old Statesville Rd, Charlotte, NC 28269-6768 | 2007-08-31 |
| 1700815487 | Dva Healthcare Renal Care Inc | Clinic/Center | 3053 State Route 35, Ste 201, Hazlet, NJ 07730-1526 | 2006-07-03 |
| 1508895632 | Dva Healthcare Renal Care Inc | Clinic/Center | 1164 E Route 130, Burlington, NJ 08016-2954 | 2006-07-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DVA HEALTHCARE RENAL CARE INC. | 2000 16th St, Jld/Secgovfin, Denver, Colorado 80202-5117 |
| Street Address |
2685 METROPOLITAN PKWY SW STE F |
| City | ATLANTA |
| State | GA |
| Zip Code | 30315-7926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686389 | Bernadette Johnson | Pharmacist | 2685 Metropolitan Pkwy Sw, Atlanta, GA 30315-7900 | 2020-10-15 |
| 1386242881 | Uchechi E. Okereke | Pharmacist | 2685 Metropolitan Pkwy Sw, Atlanta, GA 30315-7900 | 2020-10-15 |
| 1578161253 | Michael C Mgbemena | Pharmacist | 2685 Metropolitan Pkwy Sw, Atlanta, GA 30315-7900 | 2020-10-14 |
| 1285956755 | M Ouida Keith | Social Worker | 2685 Metropolitan Pkwy Sw, Atlanta, GA 30315-7900 | 2010-02-24 |
| 1518991348 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 2685 Metropolitan Pkwy Sw, Atlanta, GA 30315-7900 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083181341 | Erin Cole | Specialist/Technologist | Lakewood Ave Se, Atlanta, GA 30315 | 2018-10-25 |
| 1942701081 | Julie Crocker | Dental Hygienist | 1046 Ridge Ave. Sw, Atlanta, GA 30315 | 2018-02-23 |
| 1457695850 | Dominica Aquino Morales-gibson | Physical Therapist | 2850 Springdale Road Sw, Atlanta, GA 30315 | 2012-11-26 |
| 1912264813 | Maxwell Uhakheme | Internal Medicine | 6875 Douglas Blvd, Suite A, Kaiser Permanente Douglasville Medical Center, Douglasville, GA 30315 | 2012-04-16 |
| 1427329093 | Sulonda Smith | Counselor | 34 Atlanta Ave. Se, Hank Aaron Blvd, Atlanta, GA 30315 | 2012-01-13 |
| 1407152507 | Gerald Leroy Griffin | Pharmacist | 520 Boulevard, Atlanta, GA 30315 | 2011-02-07 |
| 1245404854 | Tunisia Finch Cornelius | Dermatology | 1039 Grant St Se Ste A-11, Atlanta, GA 30315 | 2008-04-15 |
| 1356512180 | Chandra Blakely | Counselor | 215 Lakewood Way, Suite 205, Atlanta, GA 30315 | 2008-03-19 |
| 1104043967 | Alvin H. Clair, M.d.p.c. | Dermatology | 777 Cleveland Ave.,sw Ste.500, Atlanta, GA 30315 | 2007-04-20 |
| 1396877742 | Scott M Russell | Speech-Language Pathologist | 1364 Clifton Road, Atlanta, GA 30315 | 2007-03-12 |
| Find all providers in zip 30315 | ||||
| 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 |
|---|---|---|---|---|
| 1013562818 | Menca Dialysis, LLC | Clinic/Center | 3030 Headland Dr Sw Ste C, Atlanta, GA 30311-5435 | 2019-08-08 |
| 1619475217 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 1149 Cascade Pkwy Sw, Atlanta, GA 30311-3090 | 2018-01-29 |
| 1114463601 | Total Renal Care Inc | Clinic/Center | 2045 Donald Lee Hollowell Pkwy Nw, Atlanta, GA 30318-4701 | 2017-01-09 |
| 1477985992 | Emory Dialysis, LLC | Clinic/Center | 5673 Peachtree Dunwoody Rd, Ne, Suite 501, Atlanta, GA 30342 | 2013-08-07 |
| 1558709816 | Total Renal Care Inc | Clinic/Center | 2540 Flat Shoals Rd, Atlanta, GA 30349-4314 | 2013-06-10 |
| 1295005742 | Total Renal Care Inc | Clinic/Center | 540 Central Ave Sw, Atlanta, GA 30312-2735 | 2011-12-30 |
| 1821367830 | Total Renal Care Inc | Clinic/Center | 413b Loop 59, Atlanta, TX 75551-2015 | 2011-12-20 |
| 1013142843 | Emory Dialysis, LLC | Clinic/Center | 610 Northside Dr Nw, Atlanta, GA 30318-6927 | 2009-05-22 |
| 1851594329 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 3651 Bakers Ferry Rd Sw, Atlanta, GA 30331-3712 | 2007-06-11 |
| 1417016551 | South Fulton Dialysis Center LLC | Clinic/Center | 3268 Greenbriar Pkwy Sw, Atlanta, GA 30331-2604 | 2006-12-06 |
| Find all providers in ATLANTA | ||||
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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.