NPIMap

Organization Active NPI

Total Renal Care, Inc.

Doing business as Lakeville Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lakeville, MN
National Provider Identifier
1467801860
Registry record updated Dec 19, 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
Lakeville Dialysis
Practice address
20184 Heritage Dr
Lakeville, MN 55044-6855
Phone
(952) 985-5438
Fax
(952) 469-9742
NPI assigned
Jun 7, 2016
Last updated
Dec 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 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

20184 Heritage Dr
Lakeville, MN 55044-6855

Mailing address

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

Other names 1

  • Lakeville Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160627000003 MN Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Lakeville, MN

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Lakeville DialysisCCN 242605
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Jan 25, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
8

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
24D2117007Lakeville Dialysis20184 Heritage Drive, Lakeville, MN 55044Certificate of waiverAug 7, 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

Locations

20184 Heritage Dr
Lakeville, MN 55044
Phone (952) 985-5438

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": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1467801860",
    "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": "20184 HERITAGE DR",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446855",
            "telephone_number": "952-985-5438",
            "fax_number": "952-469-9742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeville Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeville Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.