NPIMap

Organization Active NPI

Total Renal Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Manassas, VA
National Provider Identifier
1730569849
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TOTAL RENAL CARE, INC.
Practice address
9420 Forestwood LN
Ste 100
Manassas, VA 20110-4757
Phone
(703) 257-1749
NPI assigned
Jun 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

9420 Forestwood LN
Ste 100
Manassas, VA 20110-4757

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1730569849MedicaidVA

Other names 1

  • Bull Run Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150917001188 VA Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Manassas, VA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Bull Run DialysisCCN 492693
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Jan 20, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
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
Tax ID family
Davita Upstate Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

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

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752192000000",
    "number": "1730569849",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 FORESTWOOD LN",
            "address_2": "STE 100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104757",
            "telephone_number": "703-257-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-03",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730569849",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bull Run Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bull Run Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; 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.