NPIMap

Organization Active NPI

Dva Healthcare Renal Care Inc

Doing business as Durham Regional Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Durham, NC
National Provider Identifier
1831690098
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DVA HEALTHCARE RENAL CARE INC
Doing business as
Durham Regional Dialysis
Practice address
3901 N Roxboro St
Ste 108
Durham, NC 27704-2181
Phone
(919) 471-2523
Fax
(919) 471-8699
NPI assigned
Feb 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 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 Primary

Addresses

Primary practice location

3901 N Roxboro St
Ste 108
Durham, NC 27704-2181

Mailing address

5200 Virginia Way
L & C Department
Brentwod, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
1831690098MedicaidNC

Other names 1

  • Durham Regional Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180412000771 NC Part A Provider - End-Stage Renal Disease Facility (ESRD) 7517875545 Practice locations: Durham, NC

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Durham Regional DialysisCCN 342734
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Aug 13, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
10

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
34D2148332Durham Regional Dialysis3901 North Roxboro Street, Suite 108, Durham, NC 27704Certificate of waiverMay 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
CDS of Zephyrhills194 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

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

View all 14

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": "1519344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1831690098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 N ROXBORO ST",
            "address_2": "STE 108",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042181",
            "telephone_number": "919-471-2523",
            "fax_number": "919-471-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-23",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831690098",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Durham Regional Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

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