NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Cypress Gardens Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sumter, SC
National Provider Identifier
1376931154
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TOTAL RENAL CARE INC
Doing business as
Cypress Gardens Dialysis
Practice address
418 Broad St
Sumter, SC 29150
Phone
(803) 418-5129
Fax
(803) 418-0722
NPI assigned
Jan 2, 2015
Last updated
Nov 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 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 NU Primary

Addresses

Primary practice location

418 Broad St
Sumter, SC 29150

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
ERD-0220OtherSCSTATE LICENSE
RE0071MedicaidSC

Other names 1

  • Cypress Gardens Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150417000416 SC Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Sumter, SC

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Cypress Gardens DialysisCCN 422661
Overall star rating
1.0 of 5
Ownership
Profit
Certified
Dec 15, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
20

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
42D2097894Cypress Gardens Dialysis418 Broad Street, Sumter, SC 29150Certificate of waiverJun 24, 2027

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 18

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

View all 18

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": "1420156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1376931154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 BROAD ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "29150",
            "telephone_number": "803-418-5129",
            "fax_number": "803-418-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-02",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ERD-0220",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RE0071",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cypress Gardens Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cypress Gardens Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.