Usrc Valdosta Home Program LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

USRC VALDOSTA HOME PROGRAM LLC

Practice address

3564 N Crossing Cir
Valdosta, GA 31602-6412

Phone

(229) 671-4298

Fax

(229) 333-5438

NPI assigned

Oct 10, 2013

Organization subpart

Yes

Parent organization

US RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L Weinberg

Title

Senior Vice-President Gen Counsel

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• US Renal Care Valdosta Home Program Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

USRC Valdosta Home ProgramCCN 112882

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Apr 16, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

1

Listed as

USRC South GeorgiaCCN 112688

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Nov 21, 2000

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

21

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

CLIA laboratory certificates

Part of

US Renal Care Inc

Locations

Affiliated clinicians 3

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

• Olufemi Bunmi Aina, MBBS

  • Hospitalist Physician
  • Braselton, GA
  • NPI 1356690671

  Dialysis facility

  Care Compare affiliation Name & address match
• Arunas Urbonas, M.D.

  • Nephrology Physician
  • Valdosta, GA
  • NPI 1790771004

  Dialysis facility

  Care Compare affiliation Name & address match
• Nowoghomwenma Charles Ibie, MD

  • Nephrology Physician
  • Dothan, AL
  • NPI 1073742953

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1760819601",
    "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": "3564 N CROSSING CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026412",
            "telephone_number": "229-671-4298",
            "fax_number": "229-333-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC VALDOSTA HOME PROGRAM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE, INC.",
        "enumeration_date": "2013-10-10",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE-PRESIDENT GEN COUNSEL",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "US Renal Care Valdosta Home Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Urological Clinic of Valdosta PC
• Charles John Ussery, D.O.
• Louis A. Uwagerikpe, M.D.
• Val Optics Inc
• Felix G Valdez, MD
• Valdosta Addiction Associates, Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Valdosta, GA
• Providers in Valdosta, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.