NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Home Dialysis of Dayton South

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Kettering, OH
National Provider Identifier
1497059471
Registry record updated Sep 30, 2020
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
Home Dialysis of Dayton South
Practice address
3030 S Dixie Dr
Kettering, OH 45409-1516
Phone
(937) 296-1171
Fax
(937) 296-1476
NPI assigned
Jan 5, 2011
Last updated
Sep 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
John D Winstel
Title
Chief Accounting Officer
Phone
(253) 733-4501

Specialties & licenses 1

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

Addresses

Primary practice location

3030 S Dixie Dr
Kettering, OH 45409-1516

Mailing address

5200 Virginia Way
L & C Department
Brentwood, TN 37027-7569
Phone (615) 238-3051

Other identifiers 1

IdentifierTypeStateIssuer
3159415MedicaidOH

Other names 1

  • Home Dialysis of Dayton South Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110207000323 OH Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Kettering, OH

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Home Dialysis of Dayton - SouthCCN 362541
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Feb 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
2

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
36D2019921Home Dialysis of Dayton South3030 S Dixie Dr, Kettering, OH 45409Certificate of waiverFeb 8, 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 24

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

View all 24

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": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1497059471",
    "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",
            "telephone_number": "615-238-3051",
            "fax_number": "800-246-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 S DIXIE DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454091516",
            "telephone_number": "937-296-1171",
            "fax_number": "937-296-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3159415",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Dialysis of Dayton South",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Home Dialysis of Dayton South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.