Dsi Conyers, LLC

Primary specialty

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

Legal business name

DSI CONYERS, LLC

Doing business as

U.S. Renal Care Conyers Dialysis

Practice address

1927 Highway 138 North
Conyers, GA 30013-4101

Phone

(770) 483-6124

Fax

(770) 929-9091

NPI assigned

Sep 27, 2012

Last updated

Feb 15, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Conyers Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Usrc Conyers DialysisCCN 112861

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Feb 1, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

13

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

CLIA laboratory certificates

Part of

US Renal Care Inc

Member of 1

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

• Dialysis Newco LLC

  dba U.S. Renal Care Viera Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Viera, FL
  • NPI 1982970554

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ekundayo Adedapo Falase, MD

  • Nephrology Physician
  • Conyers, GA
  • NPI 1053314823
  NPD (past)

Affiliated clinicians 3

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

• Nardos K Belayneh, M.D

  • Nephrology Physician
  • Conyers, GA
  • NPI 1326384637

  Dialysis facility

  Care Compare affiliation Name & address match
• Yilikal Tassew Kassa, MD

  • Nephrology Physician
  • Conyers, GA
  • NPI 1114222676

  Dialysis facility

  Care Compare affiliation Name & address match
• Sitharam Chowdary Nandigam, MD

  • Nephrology Physician
  • Conyers, GA
  • NPI 1003096793

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1063763274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 CHURCH STREET",
            "address_2": "SUITE 1900",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192387",
            "telephone_number": "615-777-8200",
            "fax_number": "615-234-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 HIGHWAY 138 NORTH",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300134101",
            "telephone_number": "770-483-6124",
            "fax_number": "770-929-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DSI CONYERS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2012-09-27",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Conyers Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Conyers, GA
• Providers in Conyers, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.