Organization Active NPI

Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chula Vista, CA
National Provider Identifier
1568436715
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DVA RENAL HEALTHCARE INC
Practice address
630 Bay Blvd
Ste 101
Chula Vista, CA 91910-5262
Phone
(619) 420-6725
Fax
(619) 420-6736
NPI assigned
Feb 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

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

Addresses

Primary practice location

630 Bay Blvd
Ste 101
Chula Vista, CA 91910-5262

Mailing address

5200 Virginia Way
Ste 400
Brentwood, TN 37027-7569
Phone (615) 320-4435

Other identifiers 1

IdentifierTypeStateIssuer
CDC02731GMedicaidCA

Other names 1

  • Chula Vista Dialysis Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1568436715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4435",
            "fax_number": "303-209-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 BAY BLVD",
            "address_2": "STE 101",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105262",
            "telephone_number": "619-420-6725",
            "fax_number": "619-420-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-08-13",
        "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": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02731G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chula Vista Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.