Active NPI
Dva Healthcare Renal Care Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pryor, OK
National Provider Identifier
1699737809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- DVA HEALTHCARE RENAL CARE INC
- Practice address
- 309 E Graham Ave
Pryor, OK 74361-2434 - Phone
- (918) 825-3100
- Fax
- (918) 825-3183
- NPI assigned
- Apr 4, 2006
- 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
- James K Hilger
- Title
- Vice President
- Phone
- (253) 382-1919
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
309 E Graham Ave
Pryor, OK 74361-2434
Mailing address
5200 Virginia Way
Ste 400
Brentwood, TN 37027-7569
Phone (615) 320-4435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100757220C | Medicaid | OK |
Other names 1
- Pryor Dialysis
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pearsall, TX
- NPI 1194789859
Member Of
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pageland, SC
- NPI 1548222615
Member Of
Locations
309 E Graham Ave
Pryor, OK 74361
Phone 86654467413014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215561600000",
"number": "1699737809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "STE 400",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277569",
"telephone_number": "615-320-4435",
"fax_number": "866-317-3596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E GRAHAM AVE",
"city": "PRYOR",
"state": "OK",
"postal_code": "743612434",
"telephone_number": "918-825-3100",
"fax_number": "918-825-3183"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DVA HEALTHCARE RENAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-04",
"last_updated": "2008-07-09",
"status": "A",
"authorized_official_last_name": "HILGER",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "253-382-1919"
},
"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": "100757220C",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pryor Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pryor, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.