Active NPI
Dva Renal Healthcare Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Cherry Hill, NJ
National Provider Identifier
1255360384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 40401
- Legal business name
- DVA RENAL HEALTHCARE INC
- Practice address
- 1030 Kings Hwy N
Ste 100
Cherry Hill, NJ 08034-1907 - Phone
- (856) 321-0111
- Fax
- (856) 482-0263
- NPI assigned
- Jul 1, 2006
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 40401 | NJ | Primary |
Addresses
Primary practice location
1030 Kings Hwy N
Ste 100
Cherry Hill, NJ 08034-1907
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001093234 | Medicaid | DE | |
| 01831220 | Medicaid | PA | |
| 5636400 | Medicaid | NJ |
Other names 1
- Cherry Hill Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030317000046 | NJ | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 0840107611 | Practice locations: Cherry Hill, NJ |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita Cherry Hill Dialysis
- Overall star rating
- Ownership
- Profit
- Certified
- Apr 12, 1996
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 19
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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D0873118 | Cherry Hill Dialysis | Certificate of waiver | Jul 29, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Gambro Healthcare Anahe
Organizations with this tax ID in the same state 1
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Willingboro, NJ
- NPI 1346270782
Practitioners & affiliated clinicians
Affiliated clinicians 4
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": "1151712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1778803200000",
"number": "1255360384",
"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": "1030 KINGS HWY N",
"address_2": "STE 100",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080341907",
"telephone_number": "856-321-0111",
"fax_number": "856-482-0263"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DVA RENAL HEALTHCARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-01",
"last_updated": "2026-05-15",
"certification_date": "2026-05-15",
"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": "NJ",
"license": "40401",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001093234",
"state": "DE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01831220",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5636400",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Cherry Hill Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Cherry Hill Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Cherry Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.