Dva Healthcare Renal Care Inc

Primary specialty

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

License

48 Issued in TN

Legal business name

DVA HEALTHCARE RENAL CARE INC

Doing business as

Tipton County Dialysis

Practice address

107 Tennessee Ave
Covington, TN 38019-3902

Phone

(901) 475-0410

Fax

(901) 475-9040

NPI assigned

Apr 7, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Tipton County Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

DaVita Tipton County DialysisCCN 442604

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Mar 26, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

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

Tax ID family

CDS of Zephyrhills194 organizations share this tax ID, including this one

Member of 1

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

• Dva Renal Healthcare Inc

  dba Nashville Home Training Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Nashville, TN
  • NPI 1295983245

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ramakant Mahadeo Mulay, MD

  • Nephrology Physician
  • Dyersburg, TN
  • NPI 1720198013
  NPD (past)

Affiliated clinicians 2

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

• Omar O Hamze, M.D.

  • Specialist
  • Bartlett, TN
  • NPI 1437148293

  Dialysis facility

  Care Compare affiliation Name & address match
• Syed Muhammad Mohsin Raza, M.D.

  • Nephrology Physician
  • Memphis, TN
  • NPI 1992903157

  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": "1783900800000",
    "number": "1215990759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 TENNESSEE AVE",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193902",
            "telephone_number": "901-475-0410",
            "fax_number": "901-475-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TN",
            "license": "48",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442604",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3900014600",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05774858",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tipton County Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tipton County Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Dietrich, N.P
• Julia Diggs, SLP-CCC
• Docs Hometown Pharmacy LLC (Doc's Hometown Pharmacy)
• Cathy S Doyle
• Tracey Lee Duncan, OTRL
• Matthew Parker Dye
• David O Dyson
• Erica Shatalla Dyson
• Shelby East
• Edwards Enterprise & Remodeling LLC (None)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Covington, TN
• Providers in Covington, TN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.