Dca of Hawkinsville LLC

Primary specialty

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

Legal business name

DCA OF HAWKINSVILLE LLC

Doing business as

U S Renal Care Hawkinsville Dialysis

Practice address

292 Industrial Blvd
Ste 100
Hawkinsville, GA 31036-8002

Phone

(478) 892-8008

Fax

(478) 892-8040

NPI assigned

Apr 7, 2006

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

U S RENAL CARE INCAs reported in NPPES

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

Authorized official

Name

Mr. Thomas L Weinberg

Title

Vice President & Secretary

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• U S Renal Care Hawkinsville Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Usrc HawkinsvilleCCN 112707

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 19, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

16

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Dca of Hawkinsville LLC

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Carlos O Martinez, M.D.

  • Nephrology Physician
  • Macon, GA
  • NPI 1841368933

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1124081559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844631",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844631",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 INDUSTRIAL BLVD",
            "address_2": "STE 100",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310368002",
            "telephone_number": "478-892-8008",
            "fax_number": "478-892-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DCA OF HAWKINSVILLE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U S RENAL CARE INC",
        "enumeration_date": "2006-04-07",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "214-736-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000936713A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "112707",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U S Renal Care Hawkinsville Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly C Cravey, PHARMD
• Crisp RGNL Hosp Inc
• Holly Michele Cross, CNM
• Lindsey Cross
• Paige D Dawson
• Christina Marie Dokey
• Kristin L Dokey, RBT
• Robin Kicklighter Dreggors
• Alton Delana Dykes V, RPH
• Eatonton Health & Rehabilitation

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hawkinsville, GA
• Providers in Hawkinsville, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.