NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Kidney Dialysis Care Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lynwood, CA
National Provider Identifier
1376502831
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
930000083 Issued in CA
Legal business name
TOTAL RENAL CARE INC
Doing business as
Kidney Dialysis Care Unit
Practice address
3600 E Martin Luther King Jr Blvd
Lynwood, CA 90262-2607
Phone
(310) 886-5156
Fax
(310) 608-6947
NPI assigned
Mar 22, 2006
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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 930000083 CA Primary

Addresses

Primary practice location

3600 E Martin Luther King Jr Blvd
Lynwood, CA 90262-2607

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1376502831MedicaidCA

Other names 1

  • Kidney Dialysis Care Unit Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080522000655 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Lynwood, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Kidney Dialysis Care UnitCCN 052502
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Dec 14, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
40

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
05D0548329Kidney Dialysis Care Unit3600 E Martin Luther King Jr Boulevard, Lynwood, CA 90262Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 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

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1376502831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: 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": "3600 E MARTIN LUTHER KING JR BLVD",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622607",
            "telephone_number": "310-886-5156",
            "fax_number": "310-608-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "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": "CA",
            "license": "930000083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376502831",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kidney Dialysis Care Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kidney Dialysis Care Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.