NPIMap

Organization Active NPI

Columbus Rna Davita LLC

Doing business as Columbus Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Columbus, OH
National Provider Identifier
1073787248
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
0556DC Issued in OH
Legal business name
COLUMBUS RNA DAVITA LLC
Doing business as
Columbus Dialysis
Practice address
226 Graceland Blvd
Ste 3-09a
Columbus, OH 43214-1532
Phone
(614) 985-1732
Fax
(614) 781-0906
NPI assigned
Apr 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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 0556DC OH Primary

Addresses

Primary practice location

226 Graceland Blvd
Ste 3-09a
Columbus, OH 43214-1532

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2908241MedicaidOH

Other names 1

  • Columbus Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080723000219 OH Part A Provider - End-Stage Renal Disease Facility (ESRD) 4486727526 Practice locations: Columbus, OH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Columbus DialysisCCN 362543
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Feb 17, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
21

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
36D0901657Columbus Dialysis226 Graceland Blvd Ste 3-09a, Columbus, OH 43214Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Columbus Dialysis3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Locations

226 Graceland Blvd
Ste 3
Columbus, OH 43214

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 2

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": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1073787248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: 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": "226 GRACELAND BLVD",
            "address_2": "STE 3-09A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141532",
            "telephone_number": "614-985-1732",
            "fax_number": "614-781-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS RNA DAVITA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-06",
        "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": "OH",
            "license": "0556DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2908241",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbus Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Columbus Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.