Active NPI
Dva Healthcare Renal Care Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Cottage City, MD
National Provider Identifier
1891755096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- E2555
- Legal business name
- DVA HEALTHCARE RENAL CARE INC
- Practice address
- 3804 Bladensburg Rd
Cottage City, MD 20722-1613 - Phone
- (301) 277-6310
- Fax
- (301) 277-6134
- NPI assigned
- Mar 23, 2006
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | E2555 | MD | Primary |
Addresses
Primary practice location
3804 Bladensburg Rd
Cottage City, MD 20722-1613
Mailing address
5200 Virginia Way
Ste. 400 L&C
Brentwood, TN 37027-7569
Phone (615) 320-4218
Other names 1
- Cottage City Dialysis
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pearsall, TX
- NPI 1194789859
Member Of
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pageland, SC
- NPI 1548222615
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1184112000000",
"number": "1891755096",
"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": "615-320-4218",
"fax_number": "303-209-7825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3804 BLADENSBURG RD",
"city": "COTTAGE CITY",
"state": "MD",
"postal_code": "207221613",
"telephone_number": "301-277-6310",
"fax_number": "301-277-6134"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DVA HEALTHCARE RENAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-23",
"last_updated": "2007-07-11",
"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": "MD",
"license": "E2555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Cottage City Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Cottage City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.