NPIMap

Organization Active NPI

Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Myrtle Beach, SC
National Provider Identifier
1295789097
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
ERD-0163 Issued in SC
Legal business name
TOTAL RENAL CARE INC
Practice address
3919 Mayfair St
Myrtle Beach, SC 29577-5773
Phone
(843) 448-4920
Fax
(843) 448-4930
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 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 ERD-0163 SC Primary

Addresses

Primary practice location

3919 Mayfair St
Myrtle Beach, SC 29577-5773

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
ERD163MedicaidSC

Other names 1

  • Myrtle Beach Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060519000134 SC Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Myrtle Beach, SC

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Myrtle Beach DialysisCCN 422610
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Oct 27, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
16

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
42D1054162Myrtle Beach Dialysis3919 Mayfair Dr, Myrtle Beach, SC 29577Certificate of waiverMay 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Davita Upstate Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

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

View all 16

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1295789097",
    "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": "3919 MAYFAIR ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775773",
            "telephone_number": "843-448-4920",
            "fax_number": "843-448-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "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": "SC",
            "license": "ERD-0163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ERD163",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myrtle Beach Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Myrtle Beach Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.