Dva Healthcare Renal Care Inc

Primary specialty

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

License

ERD063 Issued in SC

Legal business name

DVA HEALTHCARE RENAL CARE INC

Doing business as

Winnsboro Dialysis

Practice address

1134 Kincaid Bridge Rd
Ste a
Winnsboro, SC 29180-7116

Phone

(803) 635-6096

Fax

(803) 635-6132

NPI assigned

Apr 5, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas O Usilton Jr.

Title

Group Vice President

Phone

(770) 541-7922

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Winnsboro Dialysis Doing business as

Member of 2

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

• Dva Healthcare Renal Care Inc

  dba Amelia Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Amelia Court House, VA
  • NPI 1861456113

  Member Of

  NPD member
• Dva Renal Healthcare Inc

  dba Florissant Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
  • NPI 1740241454

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1518929546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "STE. 400 L&C",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4218",
            "fax_number": "303-209-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 KINCAID BRIDGE RD",
            "address_2": "STE A",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291807116",
            "telephone_number": "803-635-6096",
            "fax_number": "803-635-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "USILTON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "GROUP VICE PRESIDENT",
        "authorized_official_telephone_number": "770-541-7922",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "SC",
            "license": "ERD063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425598",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winnsboro Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Davis and Davis Health Center
• Kathleen M Dean, LISW-CP
• Brenna B. Delaine, M.D.
• Maria Shields Dickerson, O.D.
• Margarite H. Dunn, LAC,LMSW, AADC, CS
• Jamie Easterling, FNP-C
• Eau Claire Cooperative Health Center, Inc (Cooperative Health Winnsboro)
• Catina Ellis-Patterson, CPRS, SAS
• Eye Associates of Winnsboro
• Fairfield Behavioral Health Services

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Winnsboro, SC
• Providers in Winnsboro, SC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.