NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Fountain Inn Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fountain Inn, SC
National Provider Identifier
1013235118
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
ERD0177 Issued in SC
Legal business name
TOTAL RENAL CARE INC
Doing business as
Fountain Inn Dialysis
Practice address
298 Chapman Rd
Fountain Inn, SC 29644-6129
Phone
(864) 862-2273
Fax
(864) 862-2465
NPI assigned
May 13, 2010
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samuel T Wey
Title
VP, Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X ERD0177 SC Primary

Addresses

Primary practice location

298 Chapman Rd
Fountain Inn, SC 29644-6129

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
RE0021MedicaidSC

Other names 1

  • Fountain Inn Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101229000319 SC Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Fountain Inn, SC

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Fountain Inn DialysisCCN 422616
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Jan 22, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
11

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1073932Fountain Inn Dialysis298 Chapman Rd, Fountain Inn, SC 29644Certificate of waiverSep 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Networks

  • SC HMO

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1013235118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 CHAPMAN RD",
            "city": "FOUNTAIN INN",
            "state": "SC",
            "postal_code": "296446129",
            "telephone_number": "864-862-2273",
            "fax_number": "864-862-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-13",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "SC",
            "license": "ERD0177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RE0021",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain Inn Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fountain Inn Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fountain Inn, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.