NPIMap

Organization Active NPI

Dva Healthcare Renal Care, Inc.

  • Chronic Disease Hospital
  • Yuma, AZ
National Provider Identifier
1164785747
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chronic Disease HospitalTaxonomy code 281P00000X
License
OTC-3619 Issued in AZ
Legal business name
DVA HEALTHCARE RENAL CARE, INC.
Practice address
2130 W 24TH St
Yuma, AZ 85364-6122
Phone
(928) 783-2365
NPI assigned
Jun 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Authorized official

Name
Tyler Bloom
Title
No Response Claims Manager
Phone
(253) 382-1108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chronic Disease Hospital 281P00000X OTC-3619 AZ Primary

Addresses

Primary practice location

2130 W 24TH St
Yuma, AZ 85364-6122

Mailing address

2130 W 24TH St
Yuma, AZ 85364-6122
Phone (928) 783-6122

Other names 1

  • Yuma Dialysis Other name

National Provider Directory

National Provider Directory
Tax ID family
CDS of Zephyrhills194 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

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

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1164785747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646122",
            "telephone_number": "928-783-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646122",
            "telephone_number": "928-783-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "NO RESPONSE CLAIMS MANAGER",
        "authorized_official_telephone_number": "253-382-1108"
    },
    "taxonomies": [
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": "AZ",
            "license": "OTC-3619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yuma Dialysis",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.