Csra Renal Services, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

CSRA RENAL SERVICES, LLC

Practice address

755 Medical Park Dr
Aiken, SC 29801-6306

Phone

(803) 648-0718

Fax

(803) 641-9143

NPI assigned

Apr 13, 2006

Organization subpart

No

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

Authorized official

Name

Douglas A Stahura, D.O.NPI 1467416487

Title

President

Phone

(803) 648-0718

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas A Stahura, D.O.

  • Nephrology Physician
  • Aiken, SC
  • NPI 1467416487
  Medicare reassignment Care Compare group NPD Authorized official
• Lenda Reashell Barrett, APRN

  • Nurse Practitioner
  • West Columbia, SC
  • NPI 1457965501
  Medicare reassignment Care Compare group NPD
• Sindhu Garg, MD

  • Nephrology Physician
  • Aiken, SC
  • NPI 1770623894
  Medicare reassignment Care Compare group NPD
• Amy Parrott, FNP-BC

  • Family Nurse Practitioner
  • Aiken, SC
  • NPI 1275382913

  Nephrology

  Medicare reassignment Care Compare group NPD
• Francis J Dibona, M.D.

  • Nephrology Physician
  • Aiken, SC
  • NPI 1578527867
  NPD

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1295799641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MEDICAL PARK DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016306",
            "telephone_number": "803-648-0718",
            "fax_number": "803-641-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MEDICAL PARK DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016306",
            "telephone_number": "803-648-0718",
            "fax_number": "803-641-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSRA RENAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "STAHURA",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-648-0718",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3601",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP NUMBER",
            "identifier": "7953457",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4396",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Csra Holdings LLC (Trinity Home Services Center for Hospice Palliative Care)
• Csra Holdings LLC (Trinity Home Services Home Health)
• CT Bravo, Inc. (Beltone Hearing Aid Center)
• April Michelle Cullum, MCD-SLP
• Dana Frazier Cullum, LPC
• Shelbra Cullum
• Cumberland Village at Home

• Nephrology Physician in Aiken, SC
• Providers in Aiken, SC by specialty
• Nephrology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.