NPIMap

Organization Active NPI

Dva Renal Healthcare Inc

Doing business as Florence Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Florence, AL
National Provider Identifier
1457324220
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
S3901 Issued in AL
Legal business name
DVA RENAL HEALTHCARE INC
Doing business as
Florence Dialysis
Practice address
422 E Dr Hicks Blvd Ste B
Florence, AL 35630-5730
Phone
(256) 764-5050
Fax
(256) 767-3728
NPI assigned
Feb 10, 2006
Last updated
Nov 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 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 S3901 AL Primary

Addresses

Primary practice location

422 E Dr Hicks Blvd Ste B
Florence, AL 35630-5730

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
1457324220MedicaidAL
00220710MedicaidMS
0012529MedicaidTN

Other names 1

  • Florence Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030314000001 AL Part A Provider - End-Stage Renal Disease Facility (ESRD) 0840107611 Practice locations: Florence, AL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Florence DialysisCCN 012529
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Sep 16, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
18

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
01D0641600Florence Dialysis422 E Dr Hicks Blvd, Florence, AL 35630Certificate of waiverSep 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dva Renal Healthcare Inc173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

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

Locations

422 E Dr Hicks Blvd
Ste B
Florence, AL 35630
Phone (256) 764-5050

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763942400000",
    "number": "1457324220",
    "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": "422 E DR HICKS BLVD STE B",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305730",
            "telephone_number": "256-764-5050",
            "fax_number": "256-767-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "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": "AL",
            "license": "S3901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457324220",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220710",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012529",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florence Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florence Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.