NPIMap

Organization Active NPI

Dialysis Clinic Inc

  • Clinical Medical Laboratory
  • Nashville, TN
National Provider Identifier
1780689505
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
TN 1952 Issued in TN
Legal business name
DIALYSIS CLINIC INC
Practice address
1616 Hayes St
Nashville, TN 37203-3011
Phone
(615) 321-0212
Fax
(615) 321-4880
NPI assigned
Jun 17, 2005
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DIALYSIS CLINIC INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Mr. Donovan Schultz
Title
President
Phone
(615) 327-3061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X TN 1952 TN Primary

Addresses

Primary practice location

1616 Hayes St
Nashville, TN 37203-3011

Mailing address

1616 Hayes St
Nashville, TN 37203-3011
Phone (615) 321-0212

Other identifiers 3

IdentifierTypeStateIssuer
TN 1952OtherTNSTATE LABORATORY LICENSE
05-3-TN-06-1OtherTNASHI LAB NUMBER
44D0659038OtherTNCLIA

Other names 1

  • DCI Transplant Immunology Laboratory Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090518000354 TN Part A Provider - Histocompatibility Laboratory 4284541129 Practice locations: Nashville, TN

National Provider Directory

National Provider Directory
Tax ID family
Dialysis Clinic Inc238 organizations share this tax ID, including this one
Part of
Dialysis Clinic Inc

Organizations with this tax ID in the same state 17

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

View all 17

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rancho Dialysis ClinicSacramento, CA, CCN 552519 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 24, 2003
Dec 24, 2003

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1780689505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 HAYES ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372033011",
            "telephone_number": "615-321-0212",
            "fax_number": "615-321-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 HAYES ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372033011",
            "telephone_number": "615-321-0212",
            "fax_number": "615-321-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIALYSIS CLINIC INC",
        "enumeration_date": "2005-06-17",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "TN 1952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LABORATORY LICENSE",
            "identifier": "TN 1952",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHI LAB NUMBER",
            "identifier": "05-3-TN-06-1",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "44D0659038",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DCI Transplant Immunology Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "DCI Transplant Immunology Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.