Dva Renal Healthcare Inc
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Savannah, GA
NPI 1205804309 · NPPES record last updated Jul 18, 2025
Key facts
- NPI
- 1205804309
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- License
- ESRD001082 (GA)
- Legal business name
- DVA RENAL HEALTHCARE INC
- Practice address
- 11706 Mercy Blvd Ste 9
Savannah, GA 31419-1751 - Phone
- (912) 961-6006
- Fax
- (912) 961-9257
- NPI assigned
- Mar 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Samuel T. Wey, AO
- Title
- VP, Licensure & Certification
- Phone
- (615) 341-6641
Corporate family (same tax ID) 10
Affiliated clinicians 2
-
Matthew James Day, M.D.
-
Nancy Sue Thompson, M. D.
Medicare Care Compare: Dialysis facility
- Listed as
- DaVita Abercorn Dialysis
- Overall star rating
- ★★☆☆☆ 2.0 of 5
- Ownership
- Profit
- Certified
- Jan 17, 1997
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 12
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0987542 | Abercorn Dialysis | Certificate of waiver | Jun 6, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030507000007 | GA | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 0840107611 | Practice locations: Savannah, GA |
National Provider Directory
- Tax ID family
- Gambro Healthcare Anahe
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | ESRD001082 | GA | Yes |
Addresses
Primary practice location
11706 Mercy Blvd Ste 9
Savannah, GA 31419-1751
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ER0003 | Medicaid | SC | |
| 000893153K | Medicaid | GA | |
| 890572000 | Medicaid | FL |
Other names
- Abercorn Dialysis
Other providers in Savannah, GA
- Mark W Dusek
- John Anthony Dusenbury Jr.
- John R Duttenhaver
- Benjamin Thomas Duval
- Sara Paige Duvall
- Dva Renal Healthcare Inc
- Dva Renal Healthcare Inc
- DWC-P LLC
- DWC-Sav, LLC
- Angeline D. Dy
All providers in Savannah, GA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.