DVA RENAL HEALTHCARE INC (NPI# 1184688459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184688459 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | FAIRFIELD HOME TRAINING DIALYSIS |
| Practice Address |
1210 Hicks Blvd Fairfield OH 45014-1921 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 5139391120 |
| Practice Fax Number | 5139391150 |
| Mailing Telephone | 6152383051 |
| Mailing Fax Number | 8002468346 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2019-09-18 |
| Authorized Official Name | JAMES K 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 |
0497DC | OH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2220279 | 05 | |
| KY | 3900037700 | 05 |
| Other Name | Type Code |
|---|---|
| Fairfield Home Training 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 |
1210 HICKS BLVD |
| City | FAIRFIELD |
| State | OH |
| Zip Code | 45014-1921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720042096 | Dva Healthcare Southwest Ohio LLC | Clinic/Center | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2006-04-13 |
| 1477018810 | Bullock Dialysis LLC | Clinic/Center | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2019-02-08 |
| 1861438657 | Sharad Goel | Internal Medicine | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2006-06-21 |
| 1598708612 | Frank J Albers | Internal Medicine | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326526872 | Megan Coleen Hamill | Registered Nurse | 6570 Sosna Drive, Fairfield, OH 45014 | 2018-08-06 |
| 1831695642 | James Grant Walther | Contractor | 16408 Jeanie Drive, Aurora, IN 45014 | 2018-04-02 |
| 1104339837 | Tamara Rochester | Registered Nurse | 5474 Yellowstone Dr, Fairfield, OH 45014 | 2017-11-16 |
| 1104335892 | Barbara Johnson | Registered Nurse | 2853 Saturn Drive, Fairfield, OH 45014 | 2017-09-25 |
| 1205373537 | Samuel E Ghee IIi | Counselor | Decoach Rehabilitation Center, 6570 Sosna Drive, Fairfield, OH 45014 | 2017-01-25 |
| 1669916789 | Lacretia Ancona | In Home Supportive Care | 700 Wessel Dr #181505, Fairfield, OH 45014 | 2016-12-08 |
| 1134676299 | Lynne Mutuku | Licensed Practical Nurse | 3975 Woodridge Blvd, Apt 10, Fairfield, OH 45014 | 2016-09-07 |
| 1104291020 | Mimi Supportive Hands .llc | Home Health | 6 Ridge Dr Apt 203, Cincinnati, OH 45014 | 2015-12-03 |
| 1215319181 | Brittany Beck | Social Worker | 3050 Mack Rd Ste 205, Fairfield, OH 45014 | 2015-06-26 |
| 1093193278 | Ashli Tanner | Specialist/Technologist | 8790 N. Gilmore Rd., Fairfield, OH 45014 | 2015-05-08 |
| Find all providers in zip 45014 | ||||
| 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 |
|---|---|---|---|---|
| 1942622311 | Goza Dialysis LLC | Clinic/Center | 3825 Kraus Ln Ste S, Fairfield, OH 45014-5867 | 2014-01-20 |
| 1902228513 | Dialysis Clinic Inc | Clinic/Center | 205 Ridge Rd, Fairfield, ME 04937-3376 | 2014-01-16 |
| 1790106300 | Harmony Dialysis LLC | Clinic/Center | 1800 N Texas Street, Fairfield, CA 94533-4441 | 2013-12-27 |
| 1558524512 | Total Renal Care Inc | Clinic/Center | 427 Stillson Rd, Fairfield, CT 06824-3153 | 2008-07-09 |
| 1144490178 | Southeastern Renal Dialysis L.c. | Clinic/Center | 2000 A S Main St, Fairfield, IA 52556 | 2008-03-05 |
| 1073796421 | Liberty Dialysis - Fairfield LLC | Clinic/Center | 500 Kings Hwy, Fairfield, CT 06825-4847 | 2007-12-07 |
| 1457463291 | Nna of Alabama, Inc. | Clinic/Center | 6508 Ej Oliver Blvd, Fairfield, AL 35064-1826 | 2006-08-31 |
| 1467567206 | Everest Healthcare Ohio, Inc. | Clinic/Center | 4750 Dixie Hwy, Fairfield, OH 45014-1848 | 2006-08-20 |
| 1720042096 | Dva Healthcare Southwest Ohio LLC | Clinic/Center | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2006-04-13 |
| 1396704771 | Renal Treatment Centers California Inc | Clinic/Center | 4660 Central Way, Fairfield, CA 94534-1803 | 2006-03-22 |
| Find all providers in FAIRFIELD | ||||
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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.