NPIMap

Organization Active NPI

Dialysis Clinic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cullman, AL
National Provider Identifier
1922514488
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DIALYSIS CLINIC INC
Practice address
208 Broadway Drive, SW
Cullman, AL 35055
Phone
(256) 737-8222
Fax
(256) 737-8223
NPI assigned
Dec 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Donovan Schultz
Title
President
Phone
(615) 327-3061

Specialties & licenses 1

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

Addresses

Primary practice location

208 Broadway Drive, SW
Cullman, AL 35055

Mailing address

1601 6TH Ave SE
Decatur, AL 35601-4919
Phone (256) 350-8882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180219002480 AL Part A Provider - End-Stage Renal Disease Facility (ESRD) 4284541129 Practice locations: Cullman, AL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DCI South CullmanCCN 012703
Overall star rating
3.0 of 5
Ownership
Non-profit
Certified
Nov 15, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Dialysis Clinic, Inc.
Dialysis stations
10

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
01D2154245Dialysis Clinic Inc - South Cullman208 Broadway Dr SW, Cullman, AL 35055Certificate of waiverSep 9, 2026

National Provider Directory

National Provider Directory
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 14

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

View all 14

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rancho Dialysis ClinicSacramento, CA, CCN 552519 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 24, 2003
Dec 24, 2003

NPI Registry JSON

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1922514488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 6TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014919",
            "telephone_number": "256-350-8882",
            "fax_number": "256-350-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 BROADWAY DRIVE, SW",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35055",
            "telephone_number": "256-737-8222",
            "fax_number": "256-737-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-20",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.