Organization Active NPI

Usrc Dalton LLC

Doing business as US Renal Care Dalton Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dalton, GA
National Provider Identifier
1538461884
Registry record updated Oct 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
USRC DALTON LLC
Doing business as
US Renal Care Dalton Dialysis
Practice address
1009 Professional Blvd
Dalton, GA 30720-2506
Phone
(706) 278-1070
Fax
(706) 278-0655
NPI assigned
Nov 18, 2010
Last updated
Oct 28, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
US RENAL CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2013

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

Authorized official

Name
Thomas L Weinberg
Title
Senior VP/General Counsel
Phone
(214) 736-2700

Specialties & licenses 1

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

Addresses

Primary practice location

1009 Professional Blvd
Dalton, GA 30720-2506

Mailing address

PO Box 19119
Jonesboro, AR 72403-6601
Phone (870) 931-5400

Other identifiers 1

IdentifierTypeStateIssuer
00407954AMedicaidGA

Other names 1

  • US Renal Care Dalton Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110126000150 GA Part A Provider - End-Stage Renal Disease Facility (ESRD) 8729267513 Practice locations: Dalton, GA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
USRC Dalton DialysisCCN 112524
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Jan 1, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Chain
US Renal Care, Inc.
Dialysis stations
25

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
11D0666998Usrc Dalton, LLC1009 Professional Blvd, Dalton, GA 30720Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Part of
US Renal Care Inc

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": "1290038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382918400000",
    "number": "1538461884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19119",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036601",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202506",
            "telephone_number": "706-278-1070",
            "fax_number": "706-278-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC DALTON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE INC",
        "enumeration_date": "2010-11-18",
        "last_updated": "2013-10-28",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VP/GENERAL COUNSEL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00407954A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "US Renal Care Dalton Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.