NPIMap

Organization Active NPI

Dva Healthcare Renal Care Inc

Doing business as Ozark Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ozark, AL
National Provider Identifier
1013980747
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
S2301 Issued in AL
Legal business name
DVA HEALTHCARE RENAL CARE INC
Doing business as
Ozark Dialysis
Practice address
195 Bunting Dr
Ozark, AL 36360-1101
Phone
(334) 774-1410
Fax
(334) 774-2690
NPI assigned
Feb 13, 2006
Last updated
Dec 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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 S2301 AL Primary

Addresses

Primary practice location

195 Bunting Dr
Ozark, AL 36360-1101

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
DIA2544DMedicaidAL
890060400MedicaidFL

Other names 1

  • Ozark Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030410000011 AL Part A Provider - End-Stage Renal Disease Facility (ESRD) 7517875545 Practice locations: Ozark, AL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Ozark DialysisCCN 012544
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Aug 4, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
19

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
01D0938646Ozark Dialysis195 Bunting Drive, Ozark, AL 36360Certificate of waiverJan 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Columbia Central194 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1013980747",
    "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": "195 BUNTING DR",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363601101",
            "telephone_number": "334-774-1410",
            "fax_number": "334-774-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "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": "AL",
            "license": "S2301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DIA2544D",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890060400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ozark Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ozark Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ozark, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.