Active NPI
Total Renal Care Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Statesboro, GA
National Provider Identifier
1104885110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- ESRD001071
- Legal business name
- TOTAL RENAL CARE INC
- Practice address
- 4B College Plaza
Statesboro, GA 30458-4928 - Phone
- (912) 681-4028
- Fax
- (912) 871-3615
- NPI assigned
- Mar 20, 2006
- 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
- James K Hilger
- Title
- Chief Accounting Officer
- Phone
- (253) 733-4500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | ESRD001071 | GA | Primary |
Addresses
Primary practice location
4B College Plaza
Statesboro, GA 30458-4928
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 320-4218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000619561C | Medicaid | GA |
Other names 1
- Nephrology Center of Statesboro
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142812800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1387411200000",
"number": "1104885110",
"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": "615-320-4218",
"fax_number": "303-209-7825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4B COLLEGE PLAZA",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304584928",
"telephone_number": "912-681-4028",
"fax_number": "912-871-3615"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOTAL RENAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-20",
"last_updated": "2013-12-19",
"status": "A",
"authorized_official_last_name": "HILGER",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
"authorized_official_telephone_number": "253-733-4500"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": "GA",
"license": "ESRD001071",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000619561C",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Nephrology Center of Statesboro",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Statesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.