Active NPI
Renal Carepartners of Fairfax, LLC
Doing business as U.S. Renal Care Fairfax Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Fairfax, VA
National Provider Identifier
1679559215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- RENAL CAREPARTNERS OF FAIRFAX, LLC
- Doing business as
- U.S. Renal Care Fairfax Dialysis
- Practice address
- 3930 Walnut St
Fairfax, VA 22030-4738 - Phone
- (703) 691-7820
- Fax
- (703) 691-7824
- NPI assigned
- Dec 15, 2005
- Last updated
- Jul 21, 2014
- Organization subpart
- Yes
- Parent organization
- U.S. RENAL CARE, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas L. Weinberg
- Title
- Authorized Official
- Phone
- (214) 736-2700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
3930 Walnut St
Fairfax, VA 22030-4738
Mailing address
PO Box 19119
Jonesboro, AR 72403-6601
Phone (870) 931-5400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679559215 | Medicaid | VA |
Other names 1
- U.S. Renal Care Fairfax Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030804000021 | VA | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 2961313671 | Practice locations: Fairfax, VA |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- Usrc Fairfax
- Overall star rating
- Ownership
- Profit
- Certified
- Oct 29, 2003
- Medicare certification status
- Active
- Chain
- US Renal Care, Inc.
- Dialysis stations
- 17
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
National Provider Directory
National Provider Directory- Part of
- US Renal Care Inc
Locations
3117 Momentum Pl
Chicago, IL 60689
Practitioners & affiliated clinicians
Affiliated clinicians 4
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": "1134604800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1405900800000",
"number": "1679559215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19119",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724036601",
"telephone_number": "870-931-5400",
"fax_number": "870-931-5418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3930 WALNUT ST",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220304738",
"telephone_number": "703-691-7820",
"fax_number": "703-691-7824"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RENAL CAREPARTNERS OF FAIRFAX, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
"enumeration_date": "2005-12-15",
"last_updated": "2014-07-21",
"status": "A",
"authorized_official_last_name": "WEINBERG",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "214-736-2700"
},
"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": "1679559215",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "U.S. Renal Care Fairfax Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.