NPIMap

Organization Active NPI

Dva Healthcare Renal Care, Inc.

Doing business as Tallahassee Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tallahassee, FL
National Provider Identifier
1265400501
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DVA HEALTHCARE RENAL CARE, INC.
Doing business as
Tallahassee Dialysis
Practice address
1607 Physicians Dr
Tallahassee, FL 32308-4620
Phone
(850) 878-8776
Fax
(850) 878-9004
NPI assigned
Mar 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Samuel T Wey
Title
VP, Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

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

Addresses

Primary practice location

1607 Physicians Dr
Tallahassee, FL 32308-4620

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
209491600MedicaidFL

Other names 1

  • Tallahassee Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030516000024 FL Part A Provider - End-Stage Renal Disease Facility (ESRD) 7517875545 Practice locations: Tallahassee, FL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Tallahassee DialysisCCN 102624
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Oct 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
27

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
10D0715089Tallahassee Dialysis1607 Physicians Drive, Tallahassee, FL 32308Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Columbia Central194 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Member of 1

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

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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": "1142035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1265400501",
    "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": "1607 PHYSICIANS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084620",
            "telephone_number": "850-878-8776",
            "fax_number": "850-878-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-11",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209491600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tallahassee Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tallahassee Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.