NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Jedburg Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Summerville, SC
National Provider Identifier
1679944003
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
ERD-0183 Issued in SC
Legal business name
TOTAL RENAL CARE INC
Doing business as
Jedburg Dialysis
Practice address
2897 W 5TH North St
Summerville, SC 29483-9674
Phone
(843) 873-3955
Fax
(843) 873-0266
NPI assigned
Oct 12, 2015
Last updated
Oct 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 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 ERD-0183 SC Primary

Addresses

Primary practice location

2897 W 5TH North St
Summerville, SC 29483-9674

Mailing address

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

Other names 1

  • Jedburg Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151119001340 SC Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Summerville, SC

National Provider Directory

National Provider Directory
Tax ID family
Hernando Kidney Center758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1679944003",
    "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": "2897 W 5TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294839674",
            "telephone_number": "843-873-3955",
            "fax_number": "843-873-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "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": "SC",
            "license": "ERD-0183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jedburg Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jedburg Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.