Dialysis Clinic Inc.

Primary specialty

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

Legal business name

DIALYSIS CLINIC INC.

Practice address

615 Park St
Jacksonville, FL 32204-2932

Phone

(904) 354-0409

Fax

(904) 354-0415

NPI assigned

Jul 8, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Dialysis Clinic IncCCN 102531

Overall star rating

2.0 of 5

Ownership

Non-profit

Certified

Dec 13, 1978

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Dialysis Clinic, Inc.

Dialysis stations

32

Tax ID family

Elbert P Tuttle Jr MD238 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

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

• Dialysis Clinic Inc

  dba DCI-Gainesville East

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Gainesville, FL
  • NPI 1417581810
  NPD tax ID
• Dialysis Clinic Inc

  dba DCI Jacksonville Mid-Town

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jacksonville, FL
  • NPI 1609360577
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jacksonville, FL
  • NPI 1053597666
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Gainesville, FL
  • NPI 1225469125
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jacksonville, FL
  • NPI 1720011109
  NPD tax ID
• Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Gainesville, FL
  • NPI 1972630499
  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 3

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

• Emma Piedad Bueno, M.D.

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1669806923

  Dialysis facility

  Care Compare affiliation Name & address match
• Hafiz Sarfraz Khan, MD

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1265621411

  Dialysis facility

  Care Compare affiliation Name & address match
• Haritha Sakhamuri, M.D.

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1952455297

  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": "1851324339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 CHURCH ST STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032948",
            "telephone_number": "615-342-0498",
            "fax_number": "904-354-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042932",
            "telephone_number": "904-354-0409",
            "fax_number": "904-354-0415"
        }
    ],
    "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200525500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dialogical Interaction Recovery, Corp.
• Dialysis Clinic Inc (DCI Jacksonville Mid-Town)
• Dialysis Clinic Inc.
• Dialysis Clinic Inc.
• Dialysis Clinic Inc.
• Dialysuites Bartram Park LLC
• Diamond Jax Quality Inc
• Diamond Supported Living Services, Inc.
• Andi Diamond, PA-C
• Jane Diamond, ARNP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• 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.