DVA HEALTHCARE RENAL CARE INC (NPI# 1760441802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760441802 |
| Entity Type | Organization |
| Organization Name | DVA HEALTHCARE RENAL CARE INC |
| Other Organization Name | MAGNOLIA DIALYSIS |
| Practice Address |
1125 S Burnside Ave Gonzales LA 70737-4248 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 2256444490 |
| Practice Fax Number | 2256449032 |
| Mailing Telephone | 6153416764 |
| Mailing Fax Number | 8002938339 |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2020-06-09 |
| 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 |
026 | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1385832 | 05 |
| Other Name | Type Code |
|---|---|
| Magnolia Dialysis | Doing Business As Name - Organization |
| 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 |
1125 S BURNSIDE AVE |
| City | GONZALES |
| State | LA |
| Zip Code | 70737-4248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1407461981 | Bryant Louis Bourgeois | Dentist | 13317 N Burnside, Gonzales, LA 70737 | 2020-09-11 |
| 1821612631 | Kene Anje Hamilton | Behavioral Analyst | 1028 East Worthy Street, Gonzales, LA 70737 | 2020-06-08 |
| 1801428636 | Mercedes Francis | Behavior Technician | 1023 E W Worthy Rd, Gonzales, LA 70737 | 2020-02-10 |
| 1407347586 | Functional Dme | Prosthetic/Orthotic Supplier | 219 W. Eastbank St., Ste B, Gonzales, LA 70737 | 2018-05-23 |
| 1235631789 | Transporting On Purpose | Non-emergency Medical Transport (VAN) | 42148 Conifer Drive, Gonzales, LA 70737 | 2018-03-01 |
| 1215453121 | Michelle Fuller Harris | Social Worker | 39094 N Angelle Ct, Gonzales, LA 70737 | 2017-08-22 |
| 1215452529 | Lani Litchfield | Specialist/Technologist | 13341 W. Mill Grove Dr, Gonzales, LA 70737 | 2017-08-08 |
| 1326569369 | Tyler Joshua Turner | Counselor | 1923 South Edwards, Gonzales, LA 70737 | 2017-06-29 |
| 1518408046 | Margaret Madere | Social Worker | 2827 S Ruby Street, Gonzales, LA 70737 | 2017-03-16 |
| Find all providers in zip 70737 | ||||
| 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 |
|---|---|---|---|---|
| 1861889289 | Fresenius Medical Care Capital City, LLC | Clinic/Center | 2326 South Darla Avenue, Gonzales, LA 70737 | 2015-04-23 |
| 1841253895 | Renal Treatment Centers Southeast Lp | Clinic/Center | 1406 N Sarah Dewitt Dr, Gonzales, TX 78629 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568079085 | Fresenius Medical Care Broussard, LLC | Clinic/Center | 138 Youngsville Highway, Lafayette, LA 70508-4536 | 2020-09-29 |
| 1144833872 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 330 Chavanne Street, Lake Charles, LA 70601 | 2020-08-24 |
| 1700404381 | Fresenius Medical Care Ouachita Home, LLC | Clinic/Center | 401 Thomas Rd Ste D, West Monroe, LA 71292-7902 | 2020-07-09 |
| 1255997110 | Dialysis Clinic Inc | Clinic/Center | 222 Saint Nazaire Rd, Broussard, LA 70518-4205 | 2019-05-16 |
| 1710457544 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 5820 Masonic Dr, Alexandria, LA 71301-2634 | 2018-12-05 |
| 1215407101 | Bio-medical Applications of Louisiana LLC | Clinic/Center | 634 Tunica Dr W, Marksville, LA 71351-2629 | 2018-12-04 |
| 1790263697 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 6101 Elysian Fields Ave, New Orleans, LA 70122-4209 | 2018-08-02 |
| 1881192540 | Isd Renal Inc | Clinic/Center | 3999 Highway 190 East Service Rd Ste A, Covington, LA 70433-4914 | 2018-01-29 |
| 1629583281 | Bio-medical Applications Louisiana, LLC | Clinic/Center | 2500 Louisiana Ave, New Orleans, LA 70115-6036 | 2017-12-05 |
| 1396255311 | Dialysis Clinic Inc | Clinic/Center | 2020 Bert Kouns Industrial Loop, Shreveport, LA 71118-3315 | 2017-10-04 |
| Find all providers with the same taxonomy | ||||
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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.