NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Gulf Breeze Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dunedin, FL
National Provider Identifier
1609844901
Registry record updated Sep 30, 2024
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
Gulf Breeze Dialysis Center
Practice address
1519 Main St
Dunedin, FL 34698-4650
Phone
(727) 738-4425
Fax
(727) 736-3353
NPI assigned
Mar 10, 2006
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Samuel T Wey
Title
VP Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

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

Addresses

Primary practice location

1519 Main St
Dunedin, FL 34698-4650

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
212516100MedicaidFL

Other names 1

  • Gulf Breeze Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030709000022 FL Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Dunedin, FL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Gulf Breeze Dialysis CenterCCN 102693
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Feb 9, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
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
10D0935426Gulf Breeze Dialysis Center1519 Main St, Dunedin, FL 34698Certificate of waiverOct 28, 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

Locations

1519 Main St
Dunedin, FL 34698
Phone (727) 738-4425

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

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": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1609844901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 MAIN ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346984650",
            "telephone_number": "727-738-4425",
            "fax_number": "727-736-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "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": "212516100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Breeze Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gulf Breeze Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dunedin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.