Dialysis Clinic Inc.

Primary specialty

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

License

3285ESR-6 Issued in NV

Legal business name

DIALYSIS CLINIC INC.

Practice address

1995 Errecart Blvd
100
Elko, NV 89801-8334

Phone

(775) 738-4090

Fax

(775) 738-3240

NPI assigned

Jul 8, 2006

Last updated

Oct 5, 2023By 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

Mr. Donovan Schultz

Title

President

Phone

(615) 327-3061

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Listed as

292516 Elko Dialysis (Dci)CCN 292516

Overall star rating

4.0 of 5

Ownership

Non-profit

Certified

Jun 29, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Dialysis Clinic, Inc.

Dialysis stations

9

Tax ID family

Dialysis Clinic Inc238 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.

• Dialysis Clinic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Carson City, NV
  • NPI 1669353488
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Gardnerville, NV
  • NPI 1184870248
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Carson City, NV
  • NPI 1770516155
  NPD tax ID

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Affiliated clinicians 1

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

• James E Sullivan III, D.O.

  • Nephrology Physician
  • Reno, NV
  • NPI 1467560292

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1841223237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "778 BASQUE WAY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897067935",
            "telephone_number": "775-883-5400",
            "fax_number": "775-883-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 ERRECART BLVD",
            "address_2": "100",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018334",
            "telephone_number": "775-738-4090",
            "fax_number": "775-738-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-327-3061",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NV",
            "license": "3285ESR-6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4504010",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XCDC00630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalee Desrosiers
• Dorothy J Dexter, MBA, CPA
• DHHS IHS Phoenix Area (Southern Bands Health Center)
• DHHS IHS Phoenix Area (Southern Bands Health Center)
• DHHS IHS Phoenix Area (Southern Bands Health Center)
• Norma Liliana Diaz
• Cortney Nichole Dickenson, LCSW
• Thomas Dickson, DDS
• Kevin M Dinwiddie, MD
• Madonna Leah Doke, RN

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Elko, NV
• Providers in Elko, NV by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.