Waycross Dialysis LLC

Primary specialty

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

Legal business name

WAYCROSS DIALYSIS LLC

Doing business as

Waycross Dialysis

Practice address

308 Carswell Ave
Waycross, GA 31501-4762

Phone

(912) 285-1663

Fax

(912) 285-3078

NPI assigned

Dec 30, 2008

Last updated

Aug 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jim Hilger

Title

Vice President

Phone

(253) 382-1919

Specialties & licenses 1

Addresses

Other names 1

• Waycross Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Total Renal Care Inc

  dba Satilla River Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Waycross, GA
  • NPI 1538392071

  O20090424000143

  Same enrollment

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1801032511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "STE 400 L&C",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4521",
            "fax_number": "866-594-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 CARSWELL AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014762",
            "telephone_number": "912-285-1663",
            "fax_number": "912-285-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYCROSS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-30",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JIM",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waycross Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cathleen M. Waters
• Melissa Waters, FNP-C
• Richard Watson, PHARMD
• Stephanie Hickman Watson, PHARMD
• Waycross Dialysis Facility, Inc
• Waycross Family Pharmacy (Rivers and Associates LLC)
• Waycross Family Practice
• Waycross Orthopaedics, P.C.
• Waycross Urology Clinic PC
• Kelly Beth Weber, M.ED., CCC-SLP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Waycross, GA
• Providers in Waycross, 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 Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.