Dva Renal Healthcare Inc
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Atlanta, GA
NPI 1104894344 · NPPES record last updated Sep 25, 2025
Key facts
- NPI
- 1104894344
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- License
- ESRD001026 (GA)
- Legal business name
- DVA RENAL HEALTHCARE INC
- Practice address
- 567 North Ave NE
Ste 200
Atlanta, GA 30308-2721 - Phone
- (404) 853-1662
- Fax
- (404) 853-3674
- NPI assigned
- Mar 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Samuel T Wey
- Title
- VP Licensure & Certification
- Phone
- (615) 341-6641
Corporate family (same tax ID) 10
Affiliated clinicians 3
Medicare Care Compare: Dialysis facility
- Listed as
- DaVita Atlanta Dialysis
- Overall star rating
- ★★★☆☆ 3.0 of 5
- Ownership
- Profit
- Certified
- Jul 26, 1989
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 28
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030513000005 | GA | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 0840107611 | Practice locations: Atlanta, GA |
National Provider Directory
- Tax ID family
- Gambro Healthcare Anahe
Locations
567 North Ave NE
Ste 200
Atlanta, GA 30308
Phone (404) 853-1662
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | ESRD001026 | GA | Yes |
Addresses
Primary practice location
567 North Ave NE
Ste 200
Atlanta, GA 30308-2721
Mailing address
5200 Virginia Way
Att: L&C Dept
Brentwood, TN 37027-7569
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890095700 | Medicaid | FL | |
| 000410374B | Medicaid | GA |
Other names
- Atlanta Dialysis
Other providers in Atlanta, GA
- Diane V Duvall
- Dalyngs Duvelsaint
- Yazan Duwayri
- Dva Healthcare Renal Care Inc
- Dva Healthcare Renal Care Inc
- Dva Renal Healthcare Inc
- Dva Renal Healthcare Inc
- Dva Renal Healthcare Inc
- Dva Renal Healthcare Inc
- Dva Renal Healthcare Inc
All providers in Atlanta, GA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.