NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Kennewick Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Kennewick, WA
National Provider Identifier
1790068542
Registry record updated Aug 15, 2024
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
Doing business as
Kennewick Dialysis
Practice address
3208 W 19TH Ave
Ste 101
Kennewick, WA 99337-2318
Phone
(509) 582-1677
Fax
(509) 585-5535
NPI assigned
Sep 27, 2011
Last updated
Aug 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 NU Primary

Addresses

Primary practice location

3208 W 19TH Ave
Ste 101
Kennewick, WA 99337-2318

Mailing address

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

Other names 1

  • Kennewick Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120712000575 WA Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Kennewick, WA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Kennewick DialysisCCN 502572
Overall star rating
5.0 of 5
Ownership
Profit
Certified
Jan 15, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
13

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2043426Kennewick Dialysis3208 W 19TH Ave Ste 101, Kennewick, WA 99337Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

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

View all 22

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": "1317081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1790068542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATTN 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": "3208 W 19TH AVE",
            "address_2": "STE 101",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993372318",
            "telephone_number": "509-582-1677",
            "fax_number": "509-585-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-27",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennewick Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kennewick Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.