NPIMap

Total Renal Care of North Carolina, LLC

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Kannapolis, NC

NPI 1679106900 · NPPES record last updated Dec 16, 2025

Key facts

NPI
1679106900
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
TOTAL RENAL CARE OF NORTH CAROLINA, LLC
Practice address
614 S Cannon Blvd
Kannapolis, NC 28083-5240
Phone
(704) 273-3471
Fax
(704) 273-3062
NPI assigned
Feb 14, 2020
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Affiliated clinicians 3

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

Medicare Care Compare: Dialysis facility

Listed as
DaVita Cannon Dialysis CCN 342760
Overall star rating
★★☆☆☆ 2.0 of 5
Ownership
Profit
Certified
Dec 9, 2020
Medicare certification status
Active (Provider of Services file)
Chain
DaVita
Dialysis stations
11

Source: Medicare Care Compare. Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2182681Cannon Dialysis
614 S Cannon Blvd, Kannapolis, NC 28083		Certificate of waiverApr 23, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200610000140 NC Part a Provider - End-Stage Renal Disease Facility (ESRD) 7911815592 Practice locations: Kannapolis, NC

National Provider Directory

Tax ID family
Total Renal Care of North Carolina LLC (60 organizations share this tax ID)

Locations

614 S Cannon Blvd
Kannapolis, NC 28083
Phone (704) 273-3471

Specialties & licenses

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

Addresses

Primary practice location

614 S Cannon Blvd
Kannapolis, NC 28083-5240

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
1679106900MedicaidNC

Other names

  • Cannon Dialysis Doing business as

Other providers in Kannapolis, NC

All providers in Kannapolis, NC · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in North Carolina

Sources for this page

Verify at the official NPI Registry.