Active NPI
Total Renal Care Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Hollywood, FL
National Provider Identifier
1104182492
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
- Practice address
- 2655 Hollywood Blvd
Hollywood, FL 33020-4840 - Phone
- (954) 925-9909
- Fax
- (954) 927-5852
- NPI assigned
- Apr 11, 2012
- 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
- John D Winstel
- Title
- Chief Accounting Officer
- Phone
- (253) 733-4501
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
2655 Hollywood Blvd
Hollywood, FL 33020-4840
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 320-4593
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007389100 | Medicaid | FL |
Other names 1
- Hallandale Dialysis
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1587340800000",
"number": "1104182492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "L&C DEPT",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277569",
"telephone_number": "615-320-4593",
"fax_number": "800-293-5872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2655 HOLLYWOOD BLVD",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330204840",
"telephone_number": "954-925-9909",
"fax_number": "954-927-5852"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOTAL RENAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-04-11",
"last_updated": "2020-04-20",
"certification_date": "2020-04-20",
"status": "A",
"authorized_official_last_name": "WINSTEL",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
"authorized_official_telephone_number": "253-733-4501"
},
"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": "007389100",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hallandale Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Hallandale Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.