NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Memorial Plaza Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1831477173
Registry record updated Jun 11, 2026
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
Memorial Plaza Dialysis
Practice address
3901 University Blvd S
Ste 111
Jacksonville, FL 32216-4374
Phone
(904) 731-0247
Fax
(904) 731-4046
NPI assigned
Aug 3, 2011
Last updated
Jun 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Authorized official

Name
Samuel Wey
Title
VP Licensure & Certification
Phone
(615) 341-6641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

3901 University Blvd S
Ste 111
Jacksonville, FL 32216-4374

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
004551200MedicaidFL

Other names 1

  • Memorial Plaza Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110906000276 FL Part A Provider - End-Stage Renal Disease Facility (ESRD) 5294883583 Practice locations: Jacksonville, FL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Memorial Plaza DialysisCCN 682516
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Dec 14, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
18

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
10D2029451Memorial Plaza Dialysis3901 University Blvd S Ste 111, Jacksonville, FL 32216Certificate of waiverSep 7, 2027

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 23

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

View all 23

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1831477173",
    "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": "3901 UNIVERSITY BLVD S",
            "address_2": "STE 111",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164374",
            "telephone_number": "904-731-0247",
            "fax_number": "904-731-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004551200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Plaza Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Plaza Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.