Dca of Kilmarnock, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

DCA OF KILMARNOCK, LLC

Practice address

77 Irvington Rd
Kilmarnock, VA 22482-3826

Phone

(804) 435-0888

Fax

(804) 435-0995

NPI assigned

Apr 7, 2006

Organization subpart

Yes

Parent organization

DIALYSIS CORPORATION OF AMERICA, INC.As reported in NPPES

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

Authorized official

Name

Mr. Stephen Everett

Title

Ceo

Phone

(410) 694-0500

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1497718977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 SENATE AVENUE",
            "address_2": "SUITE 300",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112339",
            "telephone_number": "717-730-9701",
            "fax_number": "717-730-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 IRVINGTON RD",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224823826",
            "telephone_number": "804-435-0888",
            "fax_number": "804-435-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DCA OF KILMARNOCK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIALYSIS CORPORATION OF AMERICA, INC.",
        "enumeration_date": "2006-04-07",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-694-0500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "210370",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kilmarnock, VA
• Providers in Kilmarnock, VA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.