Usrc Gloucester, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

USRC GLOUCESTER, LLC

Doing business as

U.S. Renal Care Gloucester Dialysis

Practice address

601 Berlin Cross Keys Rd
Sicklerville, NJ 08081-9563

Phone

(848) 202-3080

Fax

(848) 202-3324

NPI assigned

May 18, 2020

Last updated

May 18, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

President and Chairman

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Gloucester Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

USRC GloucesterCCN 312710

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Feb 24, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

10

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

CLIA laboratory certificates

Part of

US Renal Care Inc

Member of 1

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

• Virtua - West Jersey Health System, Inc.

  dba Virtua Home Care at West Jersey

  • Home Health Agency
  • Marlton, NJ
  • NPI 1316943004

  Member Of

  NPD member

Locations

Affiliated clinicians 2

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

• Arun Chawla, M.D.

  • Nephrology Physician
  • Voorhees, NJ
  • NPI 1568611630

  Dialysis facility

  Care Compare affiliation Name & address match
• Devang V Lodhavia, M.D.

  • Nephrology Physician
  • Voorhees, NJ
  • NPI 1679570634

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589760000000",
    "number": "1356963938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639939",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639939",
            "telephone_number": "848-202-3080",
            "fax_number": "848-202-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BERLIN CROSS KEYS RD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080819563",
            "telephone_number": "848-202-3080",
            "fax_number": "848-202-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC GLOUCESTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT AND CHAIRMAN",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "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": "U.S. Renal Care Gloucester Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kysha Underwood, LCADC
• Judy Pin Ung, PHARM.D
• Univita
• Daijanae Upshaw
• Kyra Urion
• Judith Chinonso Uwazuruonye
• Robert P Valentin
• Runie Valere
• Courtney Vaughn
• Jennifer Veerasamy

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.