NPIMap

Organization Active NPI

Dva Renal Healthcare, Inc.

Doing business as Orlando Home Training Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Orlando, FL
National Provider Identifier
1871561902
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DVA RENAL HEALTHCARE, INC.
Doing business as
Orlando Home Training Dialysis
Practice address
116 Sturtevant St Ste 2
Orlando, FL 32806-2021
Phone
(407) 849-1567
Fax
(407) 849-1657
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

116 Sturtevant St Ste 2
Orlando, FL 32806-2021

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
890575400MedicaidFL

Other names 1

  • Orlando Home Training Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050316000241 FL Part A Provider - End-Stage Renal Disease Facility (ESRD) 0840107611 Practice locations: Orlando, FL

National Provider Directory

National Provider Directory
Tax ID family
Gambro Healthcare Anahe173 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

Locations

116 Sturtevant St
#2
Orlando, FL 32806

116 Sturtevant St
Ste 2
Orlando, FL 32806
Phone (407) 849-1567

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1871561902",
    "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": "116 STURTEVANT ST STE 2",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062021",
            "telephone_number": "407-849-1567",
            "fax_number": "407-849-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "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": "890575400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orlando Home Training Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orlando Home Training Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.