Dsi Travelers Rest, LLC

Primary specialty

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

Legal business name

DSI TRAVELERS REST, LLC

Doing business as

U.S. Renal Care Travelers Rest Dialysis

Practice address

36 S Main St
Travelers Rest, SC 29690-1872

Phone

(864) 660-2050

NPI assigned

Nov 30, 2015

Last updated

May 19, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Travelers Rest Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Listed as

USRC Travelers Rest DialysisCCN 422660

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Nov 20, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

13

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

US Renal Care Inc

Member of 1

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

• Dialysis Newco LLC

  dba U.S. Renal Care Scottsdale Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
  • NPI 1053696674

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Istvan Gabor Bognar, MD

  • Nephrology Physician
  • Greenville, SC
  • NPI 1659354926

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1134593239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 CHURCH ST",
            "address_2": "SUITE 1900",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192301",
            "telephone_number": "615-467-0131",
            "fax_number": "615-234-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S MAIN ST",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901872",
            "telephone_number": "864-660-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DSI TRAVELERS REST, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S RENAL CARE, INC.",
        "enumeration_date": "2015-11-30",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care Travelers Rest Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Darlene Deaver, LDO
• Elisabeth Rosanne Diehl, D.O.
• Stacey Dilworth, FNP
• Sharon Dockery, LMFT
• Kaitlin Nicole Doverspike, OD
• Jacob L Duncan, PHARMD
• Courtney Eidson
• John Robert Endler, PHARMD
• Enhanced Living Travelers Rest
• Eye to Eye Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Travelers Rest, SC
• Providers in Travelers Rest, 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 May 19, 2016; 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.