DVA RENAL HEALTHCARE INC (NPI# 1154397859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154397859 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | STAMFORD DIALYSIS |
| Practice Address |
30 Commerce Rd Stamford CT 06902-4550 |
| Mailing Address |
5200 Virginia Way L & C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 2033589969 |
| Practice Fax Number | 2033599252 |
| Mailing Telephone | 6153204214 |
| Mailing Fax Number | 8669443352 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | JOHN D 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 |
0253 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02215869 | 05 | |
| CT | 004190691 | 05 | |
| NJ | 0072451 | 05 |
| Other Name | Type Code |
|---|---|
| Stamford Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629415609 | Dva Renal Healthcare Inc | Clinic/Center | 300 B 22nd St South, Birmingham, AL 35233-2209 | 2013-05-30 |
| 1164728408 | Dva Renal Healthcare Inc | Clinic/Center | 415 W Nc Hwy 54, Durham, NC 27713-7516 | 2011-02-03 |
| 1295983245 | Dva Renal Healthcare Inc | Clinic/Center | 1919 Charlotte Ave Ste 200, Nashville, TN 37203-2245 | 2008-09-03 |
| 1811171440 | Dva Renal Healthcare Inc | Clinic/Center | 300 W Broadway Ste 150, Council Bluffs, IA 51503-9077 | 2007-12-18 |
| 1881623585 | Dva Renal Healthcare Inc | Clinic/Center | 271 King St, Perth Amboy, NJ 08861-4488 | 2006-07-03 |
| 1164451852 | Dva Renal Healthcare Inc | Clinic/Center | 262 Texas Rd, Ste 101, Old Bridge, NJ 08857-4008 | 2006-07-03 |
| 1912936618 | Dva Renal Healthcare Inc | Clinic/Center | 1200 Randolph Rd, Muhlenburg Campus, Plainfield, NJ 07060-3361 | 2006-07-03 |
| 1346270782 | Dva Renal Healthcare Inc | Clinic/Center | 230 Van Sciver Pkwy, Willingboro, NJ 08046-1131 | 2006-07-03 |
| 1548299381 | Dva Renal Healthcare Inc | Clinic/Center | 29 Meridian Rd, Edison, NJ 08820-2823 | 2006-07-02 |
| 1548299373 | Dva Renal Healthcare Inc | Clinic/Center | 14-20 Prospect St, East Orange, NJ 07017-2238 | 2006-07-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DVA Renal Healthcare Inc. | 2000 16th St, Jld/secgovfin, Denver, Colorado 80202-5117 |
| Street Address |
30 COMMERCE RD |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-4550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992022008 | Revekka Babayev | Internal Medicine | 30 Commerce Rd, Stamford, CT 06902-4550 | 2010-04-28 |
| 1821264656 | Richard Martin Byrns | Physician Assistant | 30 Commerce Rd, Stamford, CT 06902-4550 | 2008-05-01 |
| 1174629588 | William Harold Hines | Internal Medicine | 30 Commerce Rd, Stamford, CT 06902-4550 | 2006-09-15 |
| 1508962093 | Eric Yale Brown | Internal Medicine | 30 Commerce Rd, Stamford, CT 06902-4550 | 2006-09-15 |
| 1760588198 | Brenda Shang Chan | Internal Medicine | 30 Commerce Rd, Stamford, CT 06902-4550 | 2006-09-15 |
| 1609800606 | Stamford Nephrology, P.C. | Internal Medicine | 30 Commerce Rd, Stamford, CT 06902-4550 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861043242 | Palak Bhambri | Pharmacist | 537 Canal Street, Stamford, CT 06902 | 2019-09-26 |
| 1730654815 | Brenice Duroseau | Nurse Practitioner | 292 Long Ridge Rd Ste 202, Stamford, CT 06902 | 2018-10-04 |
| 1447732862 | Ngoc Lam | Pharmacist | 1990 West Main Street, Stamford, CT 06902 | 2018-09-01 |
| 1336627264 | Margaret F Gorelick | Nurse Practitioner | Stamford Health, One Hospital Plaza, Stamford, CT 06902 | 2018-08-02 |
| 1174053425 | Ashley Marie Santana | Social Worker | 110 Commons Park N Apt 1158, Stamford, CT 06902 | 2017-06-19 |
| 1578090395 | Anas Al-sabbagh | Dentist | 1 Strawberry Hill Court Suite L7 Stamford, Connecticut, Stamford, CT 06902 | 2017-05-11 |
| 1154862936 | Hillary Rubin | Psychologist | 44 Commerce Avenue, Stamford, CT 06902 | 2017-03-14 |
| 1801332135 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1 Hospital Plz Ste G122, Stamford, CT 06902 | 2017-01-10 |
| 1932563277 | Mary Hurtadodemendoza | Pharmacist | 59 Courtland Ave 2m, Stamford, CT 06902 | 2016-04-13 |
| 1235592247 | Advanced Therapy and Performance LLC | Physical Medicine & Rehabilitation | 75 Selleck Street, Stamford, CT 06902 | 2016-03-29 |
| Find all providers in zip 06902 | ||||
| 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 |
|---|---|---|---|---|
| 1578838405 | Riverside Radiology Consultants, LLC | Clinic/Center | 65 Harvard Ave, Stamford, CT 06902-5564 | 2012-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750939963 | Total Renal Care Inc | Clinic/Center | 7 Cambridge Dr Ste 105, Trumbull, CT 06611-4763 | 2019-08-30 |
| 1255839494 | Total Renal Care Inc | Clinic/Center | 425 Hawley Ln, Stratford, CT 06614-1514 | 2018-01-23 |
| 1366829343 | Wallingford Dialysis Care LLC | Clinic/Center | 720 N Main Street Ext, Suites 1 - 3, Wallingford, CT 06492-2417 | 2015-04-29 |
| 1417345828 | Tross Dialysis LLC | Clinic/Center | 164 Mount Pleasant Rd, Newtown, CT 06470-1408 | 2015-01-07 |
| 1184031437 | Argyle Dialysis LLC | Clinic/Center | 51 Palomba Dr, Enfield, CT 06082-3801 | 2014-07-18 |
| 1952616633 | Total Renal Care Inc | Clinic/Center | 445e Willard Ave, Newington, CT 06111-2318 | 2010-08-18 |
| 1013228816 | Bio-medical Applications of Connecticut, Inc. | Clinic/Center | 725 Park Ave, Bloomfield, CT 06002-2402 | 2010-06-25 |
| 1386896587 | St. Raphael Dialysis Center Partnership | Clinic/Center | 266 State St, North Haven, CT 06473-2154 | 2008-10-21 |
| 1558524512 | Total Renal Care Inc | Clinic/Center | 427 Stillson Rd, Fairfield, CT 06824-3153 | 2008-07-09 |
| 1073796421 | Liberty Dialysis - Fairfield LLC | Clinic/Center | 500 Kings Hwy, Fairfield, CT 06825-4847 | 2007-12-07 |
| 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.