Active NPI
Total Renal Care Inc
Doing business as Maysville Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Maysville, KY
National Provider Identifier
1083823710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- TOTAL RENAL CARE INC
- Doing business as
- Maysville Dialysis
- Practice address
- 489 Tucker Dr
Maysville, KY 41056-9111 - Phone
- (606) 759-0923
- Fax
- (606) 759-4915
- NPI assigned
- May 21, 2007
- Last updated
- Dec 30, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | NU | Primary |
Addresses
Primary practice location
489 Tucker Dr
Maysville, KY 41056-9111
Mailing address
5200 Virginia Way
Att: L&C Department
Brentwood, TN 37027-7569
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2861452 | Medicaid | OH | |
| 7100029920 | Medicaid | KY |
Other names 1
- Maysville Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080410000294 | KY | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 8426965229 | Practice locations: Maysville, KY |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita Maysville Dialysis
- Overall star rating
- Ownership
- Profit
- Certified
- Nov 5, 2007
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 12
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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D1071159 | Maysville Dialysis | Certificate of waiver | Jul 18, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & 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": "1179705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1735516800000",
"number": "1083823710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "ATT: L&C DEPARTMENT",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "489 TUCKER DR",
"city": "MAYSVILLE",
"state": "KY",
"postal_code": "410569111",
"telephone_number": "606-759-0923",
"fax_number": "606-759-4915"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOTAL RENAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-21",
"last_updated": "2024-12-30",
"certification_date": "2024-12-30",
"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": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2861452",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100029920",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Maysville Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Maysville Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Maysville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.