Organization Active NPI

Total Renal Care Inc

Doing business as Eastern Maine Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ellsworth, ME
National Provider Identifier
1922352301
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
38840 Issued in ME
Legal business name
TOTAL RENAL CARE INC
Doing business as
Eastern Maine Dialysis
Practice address
11 Short St
Ellsworth, ME 04605-1718
Phone
(207) 667-9294
Fax
(207) 667-9414
NPI assigned
Nov 6, 2012
Last updated
Jun 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 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 38840 ME Primary

Addresses

Primary practice location

11 Short St
Ellsworth, ME 04605-1718

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1922352301MedicaidME

Other names 1

  • Eastern Maine Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121214000011 ME Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Ellsworth, ME

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Eastern Maine DialysisCCN 202514
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Nov 1, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
12

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0956298Eastern Maine Dialysis11 Short Street, Ellsworth, ME 04605Provider-performed microscopyJan 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hernando Kidney Center758 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.

Practitioners & affiliated clinicians

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1922352301",
    "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": "11 SHORT ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051718",
            "telephone_number": "207-667-9294",
            "fax_number": "207-667-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "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": "ME",
            "license": "38840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922352301",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Maine Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastern Maine Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.