Sprewell Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

SPREWELL DIALYSIS LLC

Practice address

1724 Leighton Ave
Anniston, AL 36207-3833

Phone

(256) 236-5864

Fax

(256) 741-1782

NPI assigned

Nov 11, 2013

Organization subpart

No

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

Authorized official

Name

John Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Model City Home Training Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Listed as

DaVita Model City HT at Home DialysisCCN 012685

Ownership

Profit

Certified

Jun 2, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

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

• Bainbridge Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Worth, TX
  • NPI 1699041152

  Member Of

  NPD member
• Renal Treatment Centers-Southeast, LP.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Donna, TX
  • NPI 1902353543

  Member Of

  NPD member

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jeffrey H Glaze, MD

  • Nephrology Physician
  • Homewood, AL
  • NPI 1255389896

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1669801643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4268",
            "fax_number": "877-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362073833",
            "telephone_number": "256-236-5864",
            "fax_number": "256-741-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPREWELL DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-11",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "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": "223266",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Model City Home Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Model City Home Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Anniston, AL
• Providers in Anniston, AL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.