Active NPI
Dca of Mechanicsburg LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Mechanicsburg, PA
National Provider Identifier
1083677587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- DCA OF MECHANICSBURG LLC
- Practice address
- 120 S Filbert St
Mechanicsburg, PA 17055-6539 - Phone
- (717) 790-6080
- Fax
- (717) 790-6081
- NPI assigned
- Apr 7, 2006
- Organization subpart
- Yes
- Parent organization
- U S RENAL CARE INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Thomas L Weinberg
- Title
- Vice President & Secretary
- Phone
- (214) 736-2700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
120 S Filbert St
Mechanicsburg, PA 17055-6539
Mailing address
PO Box 19119
Jonesboro, AR 72403-6601
Phone (870) 931-5400
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PPA01604 | Other | PA | PA CHRONIC RENAL |
| 01888760 | Other | PA | UNISON |
| 0018887600001 | Medicaid | PA | |
| 7278046 | Other | PA | AETNA |
| 2687877 | Other | PA | AETNA |
| 907109 | Other | PA | TUFTS HEALTH PLAN |
| 1522940 | Other | PA | GATEWAY |
| 1852 | Other | PA | PA HIGHMARK |
| 20012167 | Other | PA | AMERIHEALTH MERCY |
| 7287332 | Other | PA | AETNA US HEALTHCARE |
Other names 1
- U S Renal Care Mechanicsburg Dialysis
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529539200000",
"number": "1083677587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19119",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724036601",
"telephone_number": "870-931-5400",
"fax_number": "870-931-5418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 S FILBERT ST",
"city": "MECHANICSBURG",
"state": "PA",
"postal_code": "170556539",
"telephone_number": "717-790-6080",
"fax_number": "717-790-6081"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DCA OF MECHANICSBURG LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "U S RENAL CARE INC",
"enumeration_date": "2006-04-07",
"last_updated": "2018-06-21",
"status": "A",
"authorized_official_last_name": "WEINBERG",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
"authorized_official_telephone_number": "214-736-2700",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA CHRONIC RENAL",
"identifier": "PPA01604",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "01888760",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018887600001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7278046",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2687877",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "907109",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1522940",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA HIGHMARK",
"identifier": "1852",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY",
"identifier": "20012167",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "7287332",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "U S Renal Care Mechanicsburg Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Mechanicsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.