Active NPI
Total Renal Care Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Texarkana, TX
National Provider Identifier
1649549643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 110117
- Legal business name
- TOTAL RENAL CARE INC
- Practice address
- 5502 Medical Parkway Dr
Texarkana, TX 75503-4623 - Phone
- (903) 832-9771
- Fax
- (903) 791-1774
- NPI assigned
- Dec 20, 2011
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 110117 | TX | Primary |
Addresses
Primary practice location
5502 Medical Parkway Dr
Texarkana, TX 75503-4623
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0878068-01 | Medicaid | TX |
Other names 1
- Texarkana Regional Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120314000433 | TX | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 2365417888 | Practice locations: Texarkana, TX |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita Texarkana Regional Dialysis
- Overall star rating
- Ownership
- Profit
- Certified
- Mar 1, 1983
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 34
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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0967742 | Texarkana Regional Dialysis | Certificate of waiver | Nov 21, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Davita Upstate Dialysis
Organizations with this tax ID in the same state 3
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Mission, TX
- NPI 1801020193
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Atlanta, TX
- NPI 1821367830
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- El Paso, TX
- NPI 1972973667
Practitioners & affiliated clinicians
Affiliated clinicians 5
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": "1324339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1744848000000",
"number": "1649549643",
"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": "5502 MEDICAL PARKWAY DR",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755034623",
"telephone_number": "903-832-9771",
"fax_number": "903-791-1774"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOTAL RENAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-20",
"last_updated": "2025-04-17",
"certification_date": "2025-04-17",
"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": "TX",
"license": "110117",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0878068-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Texarkana Regional Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Texarkana Regional Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.