NPIMap

Organization Active NPI

Total Renal Care of North Carolina, LLC

Doing business as Southern Pines Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Southern Pines, NC
National Provider Identifier
1467411199
Registry record updated Jan 14, 2026
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 OF NORTH CAROLINA, LLC
Doing business as
Southern Pines Dialysis Center
Practice address
209 Windstar PL
Southern Pines, NC 28387-7086
Phone
(910) 692-6218
Fax
(910) 692-9473
NPI assigned
Mar 21, 2006
Last updated
Jan 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Samuel 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

209 Windstar PL
Southern Pines, NC 28387-7086

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
3402638MedicaidNC

Other names 1

  • Southern Pines Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000685 NC Part A Provider - End-Stage Renal Disease Facility (ESRD) 7911815592 Practice locations: Southern Pines, NC

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Southern Pines Dialysis CenterCCN 342638
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Jun 28, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
15

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
34D1023455Southern Pines Dialysis Center209 Windstar Place, Southern Pines, NC 28387Certificate of waiverMar 16, 2028

National Provider Directory

National Provider Directory
Tax ID family
Total Renal Care of North Carolina LLC60 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

Member of 1

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

Locations

209 Windstar Pl
Southern Pines, NC 28387
Phone (910) 692-6218

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1467411199",
    "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": "209 WINDSTAR PL",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877086",
            "telephone_number": "910-692-6218",
            "fax_number": "910-692-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE OF NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3402638",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Pines Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Pines Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southern Pines, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.