Nra-Holly Hill, South Carolina, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

ERD-137 Issued in SC

Legal business name

NRA-HOLLY HILL, SOUTH CAROLINA, LLC

Doing business as

Holly Hill Dialysis Clinic

Practice address

8532 Old State Rd
Holly Hill, SC 29059-8379

Phone

(803) 496-2800

Fax

(803) 496-2808

NPI assigned

Jun 13, 2006

Last updated

Oct 17, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Barry L. Blanton

Title

Vice President

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• HOLLY HILL DIALYSIS CLINIC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• National Medical Care, Inc.

  dba Fresenius Medical Care Bristol

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bristol, TN
  • NPI 1477570117

  Member Of

  NPD member

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1124061809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8532 OLD STATE RD",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290598379",
            "telephone_number": "803-496-2800",
            "fax_number": "803-496-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8532 OLD STATE RD",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290598379",
            "telephone_number": "803-496-2800",
            "fax_number": "803-496-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NRA-HOLLY HILL, SOUTH CAROLINA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2006-06-13",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "BLANTON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "SC",
            "license": "ERD-137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HOLLY HILL DIALYSIS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Mickell, BA SOCIAL WORKER
• Musc Community Physicians (MUSC Health Primary Care - Holly Hill)
• Michael James Myers, RPH
• New Phase Home Care LLC
• Newsmile
• Orangeburg Consolidated School District Three
• Rachel Osteen
• Palmetto Eye Associates (holly hill eye clinic)
• Ginger Deroche Porter, PMHNP-BC
• Mae Randolph

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Holly Hill, SC
• Providers in Holly Hill, SC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.