NPIMap

Organization Active NPI

Davita Upstate Dialysis

  • Peritoneal Dialysis Registered Nurse
  • Greenville, SC
National Provider Identifier
1114149614
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peritoneal Dialysis Registered NurseTaxonomy code 163WD1100X
License
ERD-098 Issued in SC
Legal business name
DAVITA UPSTATE DIALYSIS
Practice address
308 Mills Avenue
Greenville, SC 29605
Phone
(864) 271-3700
Fax
(864) 271-7929
NPI assigned
May 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Cynthia J. Gayle, RN
Title
Facility Administrator
Phone
(864) 271-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peritoneal Dialysis Registered Nurse 163WD1100X ERD-098 SC Primary

Addresses

Primary practice location

308 Mills Avenue
Greenville, SC 29605

Mailing address

308 Mills Avenue
Greenville, SC 29605
Phone (864) 271-3700

Other names 1

  • Upstate Dialysis #382 Other name

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114149614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 MILLS AVENUE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29605",
            "telephone_number": "864-271-3700",
            "fax_number": "864-271-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 MILLS AVENUE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29605",
            "telephone_number": "864-271-3700",
            "fax_number": "864-271-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA UPSTATE DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAYLE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "864-271-3700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WD1100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Dialysis, Peritoneal",
            "state": "SC",
            "license": "ERD-098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upstate Dialysis #382",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.