DVA RENAL HEALTHCARE INC (NPI# 1245290782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245290782 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | EFFINGHAM DIALYSIS |
| Practice Address |
904 Medical Park Dr Suite 1 Effingham IL 62401-2193 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 2173429558 |
| Practice Fax Number | 2173421049 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2020-04-17 |
| 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 |
N/A | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2300487 | 05 |
| Other Name | Type Code |
|---|---|
| Effingham 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 |
904 MEDICAL PARK DR SUITE 1 |
| City | EFFINGHAM |
| State | IL |
| Zip Code | 62401-2193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003801499 | David J Bitzer | Urology | 904 Medical Park Dr, Effingham, IL 62401-2193 | 2005-09-13 |
| 1467813022 | Shelby Renea Overbeck | Registered Nurse | 904 Medical Park Dr, Suite 2, Effingham, IL 62401-2193 | 2016-03-10 |
| 1598005993 | Ronna R Hurren | Registered Nurse | 904 Medical Park Dr, Suite 2, Effingham, IL 62401-2193 | 2013-02-21 |
| 1275873689 | Connie L Coatney | Licensed Practical Nurse | 904 Medical Park Dr, Suite 2, Effingham, IL 62401-2193 | 2013-02-21 |
| 1508060252 | Cathy Raddatz | Registered Nurse | 904 Medical Park Dr, Ste 2, Effingham, IL 62401-2193 | 2007-06-14 |
| 1699893735 | Sarah Bush Lincoln Health Center | Otolaryngology | 904 Medical Park Dr, Effingham, IL 62401-2193 | 2007-03-27 |
| 1912917188 | Ruben D Boyajian | Surgery | 904 Medical Park Dr, Suite 2, Effingham, IL 62401-2193 | 2006-08-09 |
| 1194702092 | Fred Richardson Jr. | Family Medicine | 904 Medical Park Dr, Suite 3, Effingham, IL 62401-2193 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568021269 | Rhodes To Health, LLC | Chiropractor | 200 E. Fayette Ave, Effingham, IL 62401 | 2019-06-07 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1033632187 | Diel Counseling Inc. | Counselor | 444 S. Willow #7, Effingham, IL 62401 | 2017-07-20 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1194107102 | Radhika Annam | Internal Medicine | 500 N. Maple St., Joslin Diabetes Center Affiliate At Hshs Medical Group, Effingham, IL 62401 | 2015-06-25 |
| 1912334558 | Ruben Boyajian, Md | Surgery | 904 Medical Park Drive, Suite 2, Effingham, IL 62401 | 2013-09-27 |
| 1427483502 | Daniel E Czajkowski | Physical Therapist | 2611 S Banker St, Effingham, Il, Effingham, IL 62401 | 2013-09-09 |
| 1093140501 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 1200 Network Centre Drive, Suite #2, Effingham, IL 62401 | 2013-09-04 |
| 1689926487 | Wellness Loft Inc. | Counselor | 408 South 4th St., Effingham, IL 62401 | 2012-10-04 |
| 1598011470 | Patricia R. Diel | Social Worker | 444 S. Willow, Suite 7, Effingham, IL 62401 | 2012-07-30 |
| Find all providers in zip 62401 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| 1033741608 | Fresenius Medical Care New Lenox, LLC | Clinic/Center | 662 Cedar Crossings Dr, New Lenox, IL 60451-5200 | 2020-02-11 |
| 1730725904 | Perryton Dialysis LLC | Clinic/Center | 8604 Woodward Ave, Woodridge, IL 60517-3171 | 2019-11-22 |
| 1124678529 | Dialyze Direct Il LLC | Clinic/Center | 410 S Heinlein Dr, Shelbyville, IL 62565-7800 | 2019-09-17 |
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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.