DVA HEALTHCARE RENAL CARE INC (NPI# 1972572949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972572949 |
| Entity Type | Organization |
| Organization Name | DVA HEALTHCARE RENAL CARE INC |
| Other Organization Name | WYLDS ROAD DIALYSIS |
| Practice Address |
1815 Wylds Rd Augusta GA 30909-4430 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7067330522 |
| Practice Fax Number | 7067330432 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-03-02 |
| Authorized Official Name | JOHN WINSTEL (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 |
ESRD001090 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000534388A | 05 | |
| SC | 125797 | 05 |
| Other Name | Type Code |
|---|---|
| Wylds Road 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 |
1815 WYLDS RD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-4430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| 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 |
|---|---|---|---|---|
| 1225412513 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 2470 Wrightsboro Rd, Augusta, GA 30904-6202 | 2015-07-16 |
| 1235370164 | Rai Care Centers of Georgia I LLC | Clinic/Center | 1719 Magnolia Way, Augusta, GA 30909-9482 | 2009-03-24 |
| 1225140056 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 1717 Walton Way, Augusta, GA 30904-3705 | 2006-08-31 |
| 1508978313 | Bio-medical Applications of Georgia, Inc. | Clinic/Center | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2006-08-31 |
| 1316059140 | Bio-medical Applications of Georgia Inc | Clinic/Center | 1109 Medical Center Dr Bldg H, Augusta, GA 30909-6669 | 2006-08-31 |
| 1063438042 | Bio-medical Applications of Maine, Inc. | Clinic/Center | 164 Civic Center Dr, Augusta, ME 04330-8028 | 2006-07-14 |
| 1255373437 | Ara-south Augusta Clinic LLC | Clinic/Center | 1649 Gordon Hwy, Augusta, GA 30906-2220 | 2006-06-12 |
| 1073560611 | Nra-augusta, Georgia, LLC | Clinic/Center | 2841 Deans Bridge Rd, Augusta, GA 30906-2704 | 2006-05-28 |
| 1194772947 | Ara-augusta Clinic LLC | Clinic/Center | 1000 Telfair St, Augusta, GA 30901-2208 | 2006-05-27 |
| 1356749212 | South Augusta Dialysis Clinic LLC | Clinic/Center | 3206 Peach Orchard Rd, Augusta, GA 30906-3540 | 2014-12-09 |
| Find all providers in AUGUSTA | ||||
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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.