NPIMap

Organization Active NPI

Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Columbus, OH
National Provider Identifier
1861456121
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
0693DC Issued in OH
Legal business name
DVA RENAL HEALTHCARE INC
Practice address
415 E Mound St
Columbus, OH 43215-5512
Phone
(614) 288-1773
Fax
(614) 228-1881
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Authorized official

Name
Thomas O Usilton Jr.
Title
Group Vice President
Phone
(770) 541-7922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 0693DC OH Primary

Addresses

Primary practice location

415 E Mound St
Columbus, OH 43215-5512

Mailing address

5200 Virginia Way
Ste 400 L&C
Brentwood, TN 37027-7569
Phone (615) 320-4521

Other identifiers 2

IdentifierTypeStateIssuer
2572747MedicaidOH
02553097MedicaidNY

Other names 1

  • Columbus Downtown Dialysis Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1861456121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "STE 400 L&C",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4521",
            "fax_number": "866-594-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E MOUND ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155512",
            "telephone_number": "614-288-1773",
            "fax_number": "614-228-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "USILTON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "GROUP VICE PRESIDENT",
        "authorized_official_telephone_number": "770-541-7922",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "OH",
            "license": "0693DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2572747",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02553097",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbus Downtown Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.