NPIMap

Organization Active NPI

Dialysis Clinic, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • East Liverpool, OH
National Provider Identifier
1477586857
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
0562DC Issued in OH
Legal business name
DIALYSIS CLINIC, INC.
Practice address
325 W 6TH St
East Liverpool, OH 43920-2803
Phone
(330) 382-0835
Fax
(330) 382-0840
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Mr. Donovan Schultz
Title
President
Phone
(615) 327-3061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 0562DC OH Primary

Addresses

Primary practice location

325 W 6TH St
East Liverpool, OH 43920-2803

Mailing address

325 W 6TH St
East Liverpool, OH 43920-2803
Phone (330) 382-0835

Other identifiers 3

IdentifierTypeStateIssuer
0005814000MedicaidWV
01704094MedicaidPA
0744127MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100308000920 OH Part A Provider - End-Stage Renal Disease Facility (ESRD) 4284541129 Practice locations: East Liverpool, OH

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Dci - East LiverpoolCCN 362516
Overall star rating
3.0 of 5
Ownership
Non-profit
Certified
Nov 8, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Dialysis Clinic, Inc.
Dialysis stations
22

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
36D0676282Dialysis Clinic, Inc325 West Sixth Street, East Liverpool, OH 43920Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Elbert P Tuttle Jr MD238 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

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

Locations

325 W 6th St
East Liverpool, OH 43920
Phone (330) 382-0835

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rancho Dialysis ClinicSacramento, CA, CCN 552519 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 24, 2003
Dec 24, 2003

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1477586857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W 6TH ST",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439202803",
            "telephone_number": "330-382-0835",
            "fax_number": "330-382-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W 6TH ST",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439202803",
            "telephone_number": "330-382-0835",
            "fax_number": "330-382-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OH",
            "license": "0562DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005814000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01704094",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0744127",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Liverpool, OH

Sources for this page

Verify at the official NPI Registry.