DVA HEALTHCARE RENAL CARE INC (NPI# 1720047301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720047301 |
| Entity Type | Organization |
| Organization Name | DVA HEALTHCARE RENAL CARE INC |
| Other Organization Name | SOUTH CHARLOTTE DIALYSIS |
| Practice Address |
10504 Park Rd Charlotte NC 28210-8405 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9803994784 |
| Mailing Telephone | 6153204593 |
| Mailing Fax Number | 8002935872 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 6153415875 |
| Is Organization Subpart | Y |
| Parent Organization Name | DAVITA INC |
| 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 |
|---|---|---|---|
| SC | NDC002 | 05 | |
| NC | 3412523 | 05 |
| Other Name | Type Code |
|---|---|
| South Charlotte Dialysis | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6450 Bannington Rd, Charlotte, NC 282261327 | 7045429499 | 7045428234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831690098 | Dva Healthcare Renal Care Inc | Clinic/Center | 3901 N Roxboro St Ste 108, Durham, NC 27704-2181 | 2018-02-23 |
| 1639695984 | Dva Healthcare Renal Care Inc | Clinic/Center | 209 Nc Highway 111 S, Goldsboro, NC 27534-9253 | 2017-08-18 |
| 1710351531 | Dva Healthcare Renal Care Inc | Clinic/Center | 101 Davita Ln, Elizabeth City, NC 27909-3314 | 2015-11-17 |
| 1851769848 | Dva Healthcare Renal Care Inc | Clinic/Center | 9622 Kincey Ave, Huntersville, NC 28078-9140 | 2015-09-08 |
| 1447643408 | Dva Healthcare Renal Care Inc | Clinic/Center | 1274 Ruin Creek Road, Henderson, NC 27537-4168 | 2015-03-13 |
| 1205116167 | Dva Healthcare Renal Care Inc | Clinic/Center | 11308 Hawthorne Dr, Mint Hill, NC 28227-9300 | 2011-08-24 |
| 1932363744 | Dva Healthcare Renal Care Inc | Clinic/Center | 7260 E Marshville Blvd, Marshville, NC 28103-1191 | 2008-07-11 |
| 1689868739 | Dva Healthcare Renal Care Inc | Clinic/Center | 6620 Old Statesville Rd, Charlotte, NC 28269-6768 | 2007-08-31 |
| 1700815487 | Dva Healthcare Renal Care Inc | Clinic/Center | 3053 State Route 35, Ste 201, Hazlet, NJ 07730-1526 | 2006-07-03 |
| 1508895632 | Dva Healthcare Renal Care Inc | Clinic/Center | 1164 E Route 130, Burlington, NJ 08016-2954 | 2006-07-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DVA HEALTHCARE RENAL CARE INC. | 2000 16th St, Jld/Secgovfin, Denver, Colorado 80202-5117 |
| Street Address |
10504 PARK RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-8405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760475537 | Charlotte Pain Associates Pa | Anesthesiology | 10504 Park Rd, Suite 100, Charlotte, NC 28210-8405 | 2005-08-26 |
| 1508182361 | Nead Medical PC. | Clinic/Center | 10504 Park Rd, Charlotte, NC 28210-8405 | 2010-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
| Find all providers in zip 28210 | ||||
| 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 |
|---|---|---|---|---|
| 1639671357 | Total Renal Care of North Carolina LLC | Clinic/Center | 9562 Rocky River Rd, Charlotte, NC 28215 | 2018-03-08 |
| 1851891774 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 3211 Bishops Way Lane, Charlotte, NC 28215 | 2018-02-16 |
| 1821500661 | Dva Healthcare Renal Care, Inc. | Clinic/Center | 5601 Tuckaseegee Rd, Charlotte, NC 28208-2525 | 2017-11-02 |
| 1952833188 | Captree Dialysis LLC | Clinic/Center | 5100 Reagan Drive, Ste 10, Charlotte, NC 28206-1353 | 2017-03-28 |
| 1528438215 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 14166 Steele Creek Rd, Charlotte, NC 28273-3968 | 2015-10-07 |
| 1689868739 | Dva Healthcare Renal Care Inc | Clinic/Center | 6620 Old Statesville Rd, Charlotte, NC 28269-6768 | 2007-08-31 |
| 1538259031 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 928 Baxter St, Charlotte, NC 28204-2802 | 2006-10-13 |
| 1629168125 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 5220 N Tryon St, Suite A, Charlotte, NC 28213-7070 | 2006-10-13 |
| 1083704589 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 7901 England St, Charlotte, NC 28273-5915 | 2006-10-13 |
| 1609988419 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 1334 Central Ave, Charlotte, NC 28205-5010 | 2006-08-31 |
| Find all providers in CHARLOTTE | ||||
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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.