Swanville Dialysis, LLC

Primary specialty

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

Legal business name

SWANVILLE DIALYSIS, LLC

Practice address

105 Adair Dr Ste B
Goldsboro, NC 27530-4516

Phone

(615) 341-5875

NPI assigned

Sep 22, 2023

Organization subpart

No

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

Addresses

Other names 1

• Eagles Nest Home Training Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

DaVita Eagles Nest Home TrainingCCN 342771

Ownership

Profit

Certified

Jun 12, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

3

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Napa, CA
  • NPI 1295024206

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1801675558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "LICENSURE & CERTIFICATION",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-341-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ADAIR DR STE B",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304516",
            "telephone_number": "615-341-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWANVILLE DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-22",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagles Nest Home Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eagles Nest Home Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sutton'S Retirement Center
• Swack Medical Associates
• Lydia Asper Swackhammer, CPNP
• Randy L Swackhammer, M.D.
• Joseph Swales, RDN, CDCES
• Mark Gregory Swedenburg, MD
• Rita Sweet
• Misha Monette Sykes
• Synergy Wellness Clinic, PLLC
• T Gibson Blackman

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.