NPIMap

Organization Active NPI

Dialysis Clinic Inc

Doing business as DCI Henderson

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Henderson, TN
National Provider Identifier
1235731407
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DIALYSIS CLINIC INC
Doing business as
DCI Henderson
Practice address
1126 Industrial Drive
Henderson, TN 38340
Phone
(731) 668-0800
Fax
(731) 668-1994
NPI assigned
Nov 12, 2020
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Donovan Schultz
Title
President
Phone
(615) 327-3061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1126 Industrial Drive
Henderson, TN 38340

Mailing address

1633 Church St Ste 500
Nashville, TN 37203-2948
Phone (615) 327-3061

Other names 1

  • DCI Henderson Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211110002477 TN Part A Provider - End-Stage Renal Disease Facility (ESRD) 4284541129 Practice locations: Henderson, TN

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DCI HendersonCCN 442769
Overall star rating
4.0 of 5
Ownership
Non-profit
Certified
Nov 23, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Dialysis Clinic, Inc.
Dialysis stations
17

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2221580Dialysis Clinic, Inc1126 Industrial Drive, Henderson, TN 38340Certificate of waiverApr 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Margaret Dillard MD238 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

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

View all 20

Locations

1126 Industrial Dr
Henderson, TN 38340
Phone (731) 668-0800

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rancho Dialysis ClinicSacramento, CA, CCN 552519 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 24, 2003
Dec 24, 2003

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1235731407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 CHURCH ST STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032948",
            "telephone_number": "615-327-3061",
            "fax_number": "615-329-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 INDUSTRIAL DRIVE",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "38340",
            "telephone_number": "731-668-0800",
            "fax_number": "731-668-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-12",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061"
    },
    "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": "DCI Henderson",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DCI Henderson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, TN

Sources for this page

Verify at the official NPI Registry.