DVA RENAL HEALTHCARE INC (NPI# 1376516039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376516039 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | CENTRAL LITTLE ROCK DIALYSIS |
| Practice Address |
6 Freeway Dr Suite 100 Little Rock AR 72204-2486 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 5016646754 |
| Practice Fax Number | 5012969942 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2018-11-19 |
| 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 |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1501611 | 05 | |
| MS | 02520061 | 05 | |
| AR | 150329734 | 05 | |
| MO | 503272502 | 05 | |
| NY | 02529000 | 05 | |
| TN | 0042571 | 05 |
| Other Name | Type Code |
|---|---|
| Central Little Rock 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 |
6 FREEWAY DR SUITE 100 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72204-2486 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952966 | Shane Wilson | Non-emergency Medical Transport (VAN) | 1522 S Tyler St, Little Rock, AR 72204 | 2018-08-16 |
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1275056004 | University of Arkansas for Medical Sciences | Orthopaedic Surgery | 108015 Colonel Glenn Rd, Little Rock, AR 72204 | 2017-07-24 |
| 1265954820 | Marilyn Marie Lynch | Registered Nurse | 7723 Colonel Glenn Road, Little Rock, AR 72204 | 2017-07-14 |
| 1962852954 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1122 S. University Ave, Little Rock, AR 72204 | 2016-06-21 |
| 1841607751 | Charity Gillespie | Registered Nurse | 5210 Timberland Dr, Little Rock, AR 72204 | 2014-07-14 |
| 1043625221 | Interventional Surgery Institute of Little Rock, LLC | Clinic/Center | 9 Freeway Drive, Suite A, Little Rock, AR 72204 | 2014-06-25 |
| 1548696065 | Jamie Washington | Prosthetic/Orthotic Supplier | 4701 Westwood Ave, Little Rock, AR 72204 | 2013-09-16 |
| 1124468913 | Stephanie Rachelle Jez | Genetic Counselor, MS | 5800 West 10th Street, Freeway Medical Building, Suite 7-500, Little Rock, AR 72204 | 2013-06-26 |
| 1336492321 | Alton Charles Phillips Sr. | Counselor | 4400shuffield Drive, Little Rock, AR 72204 | 2012-10-16 |
| Find all providers in zip 72204 | ||||
| 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 |
|---|---|---|---|---|
| 1447640917 | Fidelity Home Dialysis Corporation | Clinic/Center | 9421 W Markham St, Little Rock, AR 72205-2240 | 2015-02-04 |
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| 1922346147 | Dialysis Clinic Inc. | Clinic/Center | 2800 W 10th St, Suite 510, Little Rock, AR 72204-2206 | 2013-01-23 |
| 1023313988 | Capes Dialysis LLC | Clinic/Center | 2 Lile Court, Ste 102-a, Little Rock, AR 72205-6241 | 2011-01-24 |
| 1679845580 | Bio-medical Applications of Arkansas, Inc. | Clinic/Center | 5320 W 12th St, Little Rock, AR 72204-1859 | 2012-02-08 |
| 1619274735 | Westside Dialysis Unit LLC | Clinic/Center | 1515 Kanis Park Dr, Suite A, Little Rock, AR 72205-4569 | 2011-02-25 |
| 1821100728 | Little Rock Dialysis Inc | Clinic/Center | 10310 W Markham St, Suite 100, Little Rock, AR 72205-2175 | 2006-08-31 |
| 1306876925 | Baptist Health | Clinic/Center | 9601 Baptist Health Drive, Little Rock, AR 72205 | 2006-07-03 |
| 1790728079 | St. Vincent Infirmary Medical Center | Clinic/Center | 2 Saint Vincent Cir, Little Rock, AR 72205-5423 | 2006-06-14 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72204 |
Please comment or provide details below to improve the information on DVA RENAL HEALTHCARE INC.
| 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.