Total Renal Care Inc

Primary specialty

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

License

110119 Issued in TX

Legal business name

TOTAL RENAL CARE INC

Doing business as

Northeast Texas Dialysis

Practice address

413B Loop 59
Atlanta, TX 75551-2015

Phone

(903) 799-5843

Fax

(903) 796-1137

NPI assigned

Dec 20, 2011

Last updated

Nov 14, 2024By 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

Samuel T Wey

Title

VP Licensure&Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northeast Texas Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita Northeast Texas DialysisCCN 452710

Overall star rating

3.0 of 5

Ownership

Profit

Certified

May 1, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

13

Tax ID family

Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 3

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

• Total Renal Care Inc

  dba Texarkana Regional Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Texarkana, TX
  • NPI 1649549643
  NPD tax ID
• Total Renal Care Inc

  dba Mission Valley Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mission, TX
  • NPI 1801020193
  NPD tax ID
• Total Renal Care Inc

  dba Ridgecrest Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • El Paso, TX
  • NPI 1972973667
  NPD tax ID

Affiliated clinicians 3

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

• Hayden N Hemphill, MD

  • Nephrology Physician
  • Texarkana, TX
  • NPI 1396746376

  Dialysis facility

  Care Compare affiliation Name & address match
• Robert James Leach, MD

  • Nephrology Physician
  • Texarkana, TX
  • NPI 1114910411

  Dialysis facility

  Care Compare affiliation Name & address match
• John O Stevens, MD

  • Nephrology Physician
  • Texarkana, TX
  • NPI 1508886482

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1821367830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "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": "413B LOOP 59",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "755512015",
            "telephone_number": "903-799-5843",
            "fax_number": "903-796-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "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": "TX",
            "license": "110119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311327601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Texas Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northeast Texas Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie A Stone, APRN, FNP-C
• Swanson Family Chiropractic P.C.
• Trevor James Swanson, D.C.
• TD Stanley PLLC
• Kelli Michelle Thompson, APRN, FNP-C
• Robert Terry Trawnik, B.C.O.
• Rosharon Shunta Turner, LPC
• Kayla Underwood, FNP
• Jennifer Wagner, LPC, LCDC
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 100226)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Atlanta, TX
• Providers in Atlanta, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.