Organization Active NPI

Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Birmingham, AL
National Provider Identifier
1629415609
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
S3734 Issued in AL
Legal business name
DVA RENAL HEALTHCARE INC
Practice address
300 B 22ND St South
Birmingham, AL 35233-2209
Phone
(205) 250-6757
Fax
(205) 458-0146
NPI assigned
May 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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 S3734 AL Primary

Addresses

Primary practice location

300 B 22ND St South
Birmingham, AL 35233-2209

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
156375MedicaidAL

Other names 1

  • Red Mountain Home Training Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130730000702 AL Part A Provider - End-Stage Renal Disease Facility (ESRD) 0840107611 Practice locations: Birmingham, AL

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
01D2065082Red Mountain Home Training Dialysis300 B 22ND St South, Birmingham, AL 35233Certificate of waiverSep 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Gambro Healthcare Anahe173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations (25 of 127)

1000 W Lake Mall
Ste 101
Bessemer, AL 35020
Phone (205) 424-1848

1917 32nd Ave N
Birmingham, AL 35207
Phone (205) 297-9052

300 22nd St S
#B
Birmingham, AL 35233
Phone (205) 250-6757

216 Marengo St
#1
Florence, AL 35630
Phone (256) 764-5050

14897 Highway 43
Russellville, AL 35653
Phone (256) 332-7044

1385 W Fort Williams St
Sylacauga, AL 35150
Phone (256) 249-4994

6 Freeway Dr
Ste 100
Little Rock, AR 72204
Phone (501) 664-6754

5800 W 10th St
Ste 510
Little Rock, AR 72204
Phone (501) 661-7930

1231 W Target Range Rd
Nogales, AZ 85621
Phone (520) 287-6597

6420 E Broadway Blvd
Ste C300
Tucson, AZ 85710
Phone (520) 299-4345

3662 S 16th Ave
Tucson, AZ 85713
Phone (520) 882-9665

1107 W La Palma Ave
Anaheim, CA 92801
Phone (714) 502-2400

3126 Professional Dr
Ste 100
Auburn, CA 95603
Phone (530) 886-8221

332 Santa Fe Dr
Ste 100
Encinitas, CA 92024
Phone (619) 287-8796

203 E 2nd Ave
Escondido, CA 92025
Phone (760) 632-2323

238 Orangefair Mall
Fullerton, CA 92832
Phone (714) 447-3045

776 Freeman Ln
Grass Valley, CA 95949
Phone (530) 477-0734

16892 Bolsa Chica St
Ste 100
Huntington Beach, CA 92649
Phone (714) 846-2102

16892 Bolsa Chica St
Huntington Beach, CA 92649
Phone (714) 846-2102

4632 W Century Blvd
Inglewood, CA 90304
Phone (310) 677-4262

9870 Genesee Ave
La Jolla, CA 92037
Phone (858) 453-9070

2021 S Flower St
Los Angeles, CA 90007
Phone (213) 745-4222

8635 W 3rd St
Ste 560W
Los Angeles, CA 90048
Phone (310) 855-1742

3393 G St
Ste A
Merced, CA 95340
Phone (209) 723-0013

10700 MacArthur Blvd
Bldg 7
Oakland, CA 94605
Phone (510) 568-5849

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1629415609",
    "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": "300 B 22ND ST SOUTH",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332209",
            "telephone_number": "205-250-6757",
            "fax_number": "205-458-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-30",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "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": "AL",
            "license": "S3734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156375",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Mountain Home Training Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Red Mountain Home Training Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.