DVA RENAL HEALTHCARE INC (NPI# 1578524104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578524104 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | ST JOSEPH DIALYSIS |
| Practice Address |
5514 Corporate Dr Ste 100 Saint Joseph MO 64507-7754 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 8166711948 |
| Practice Fax Number | 8166711909 |
| Mailing Telephone | 6153416264 |
| Mailing Fax Number | 8002972925 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2020-09-09 |
| 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 |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100359960H | 05 | |
| MO | 504868902 | 05 |
| Other Name | Type Code |
|---|---|
| St Joseph 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 |
5514 CORPORATE DR STE 100 |
| City | SAINT JOSEPH |
| State | MO |
| Zip Code | 64507-7754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346644044 | Janaha Anderson | Dental Hygienist | 4073 Se Cunningham Rd, St. Joseph, MO 64507 | 2014-10-09 |
| 1518229772 | Andrew L Walker | Radiology | 902 N Riverside Rd Ste 201, Saint Joseph, MO 64507 | 2012-06-13 |
| 1619105731 | Pamela M. Lotz | Clinical Nurse Specialist | 902 No. Riverside Rd, Suite 200, St. Joseph, MO 64507 | 2009-06-26 |
| 1356300735 | St Joseph Oncology Inc | Internal Medicine | 902 No Riverside Rd, Suite 200, St Joseph, MO 64507 | 2006-03-22 |
| 1962478560 | Douglas Chyatte | Neurological Surgery | 802 N Riverside Rd Ste 120, Saint Joseph, MO 64507 | 2006-02-24 |
| 1073089546 | Chaz Caleb Johnson | Physical Therapist | 5506 Corporate Dr Ste 1800, Saint Joseph, MO 64507 | 2018-10-22 |
| 1295228344 | Julie Odonnell Phd LLC | Clinic/Center | 708 S Woodbine Rd Ste A, Saint Joseph, MO 64507 | 2018-06-13 |
| 1912369695 | Luke Nathan Prest | Pediatrics | 902 N Riverside Rd Ste 100, Saint Joseph, MO 64507 | 2016-03-22 |
| 1396007894 | Brian Wright Roe | Internal Medicine | 5514 Corporate Dr Ste 150, Saint Joseph, MO 64507 | 2012-06-11 |
| 1861873952 | Edison Derr II | Specialist/Technologist | 2214 Maple St, Saint Joseph, MO 64507-1413 | 2015-06-15 |
| Find all providers in zip 64507 | ||||
| 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 |
|---|---|---|---|---|
| 1932209350 | Lakeland Hospitals At Niles and St Joseph, Inc | Clinic/Center | 3772 Hollywood Rd, Saint Joseph, MI 49085-9550 | 2006-09-25 |
| 1013231620 | Liberty Dialysis - Lakeland LLC | Clinic/Center | 3772 Hollywood Rd, Saint Joseph, MI 49085-9550 | 2010-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748110 | Westbrook Dialysis, LLC | Clinic/Center | 140 West Drive, Cape Girardeau, MO 63701 | 2020-10-22 |
| 1902415284 | Fresenius Medical Care Creve Coeur Home Therapies, LLC | Clinic/Center | 450 N New Ballas Rd Ste 170, Creve Coeur, MO 63141-6835 | 2020-07-23 |
| 1730716085 | Fresenius Medical Care Creve Coeur, LLC | Clinic/Center | 450 North New Bassas Road, Suite 180, Creve Coeur, MO 63141-6835 | 2020-03-26 |
| 1285109041 | Branson Kidney Center LLC | Clinic/Center | 17829 Bus 13, Branson West, MO 65737 | 2018-10-09 |
| 1790271864 | Dialysis Clinic Inc | Clinic/Center | 3101 W Broadway Ste 115, Columbia, MO 65203-0496 | 2018-07-02 |
| 1033602990 | Lantell Dialysis LLC | Clinic/Center | 8608 E 63rd St, Kansas City, MO 64133-4725 | 2018-06-14 |
| 1851892731 | Sparda Dialysis LLC | Clinic/Center | 40 Walters Pl, House Springs, MO 63051-1491 | 2018-02-26 |
| 1063923753 | Isd Renal Inc | Clinic/Center | 1702 E 10th St Ste C, Rolla, MO 65401-4600 | 2017-10-20 |
| 1063923977 | Total Renal Care Inc | Clinic/Center | 802 Jules St, St Joseph, MO 64501-1944 | 2017-10-18 |
| 1942710991 | Washington University | Clinic/Center | 272 Mayfair Plaza Shopping Ctr, Florissant, MO 63033-8009 | 2017-10-04 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 64507 |
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.