Clinton Dialysis Clinic LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

CLINTON DIALYSIS CLINIC LLC

Practice address

103 Ab Jacks Rd
Clinton, SC 29325-2112

Phone

(864) 833-0150

Fax

(864) 833-0151

NPI assigned

Mar 24, 2015

Organization subpart

No

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

Authorized official

Name

Sara Anne Brady

Title

Chief Nursing Officer

Phone

(208) 371-7878

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Listed as

Clinton Dialysis ClinicCCN 422662

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jan 7, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

American Renal Associates

Dialysis stations

20

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joachim E Hertel, MD

  • Nephrology Physician
  • Greenville, SC
  • NPI 1538146303
  NPD (past)

Affiliated clinicians 1

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

• Joachim E Hertel, MD

  • Nephrology Physician
  • Greenville, SC
  • NPI 1538146303

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1053705483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 AB JACKS RD",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293252112",
            "telephone_number": "864-833-0150",
            "fax_number": "864-833-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 AB JACKS RD",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293252112",
            "telephone_number": "864-833-0150",
            "fax_number": "864-833-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON DIALYSIS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "208-371-7878"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RE0074",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Olson Childers, DMD
• Bethany Jo Davis Christie, BCBA
• Clear Skye Medical Holdings, LLC
• Clinton Crack House
• Clinton Dental Care LLC
• Clinton Discount Pharmacy LLC
• Clinton Family Practice, Inc.
• Shelley Colip
• Sarah Kathryn Cook
• Kevin Council Coppedge, D.O.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Clinton, SC
• Providers in Clinton, SC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.