Organization Active NPI

Total Renal Care Inc

Doing business as South Williamson Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • South Williamson, KY
National Provider Identifier
1932351848
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TOTAL RENAL CARE INC
Doing business as
South Williamson Dialysis
Practice address
204 Appalachian PLZ
South Williamson, KY 41503-9404
Phone
(606) 237-6221
Fax
(606) 237-6223
NPI assigned
Oct 22, 2008
Last updated
Jul 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Authorized official

Name
John D Winstel
Title
Chief Accounting Officer
Phone
(253) 733-4501

Specialties & licenses 1

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

Addresses

Primary practice location

204 Appalachian PLZ
South Williamson, KY 41503-9404

Mailing address

5200 Virginia Way
Att: L&C Dept
Brentwood, TN 37027-7569
Phone (615) 238-3051

Other identifiers 2

IdentifierTypeStateIssuer
3810015778MedicaidWV
7100112100MedicaidKY

Other names 1

  • South Williamson Dialysis Doing business as

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
18D1094938South Williamson Dialysis204 Appalachian Plaza, South Williamson, KY 41503Certificate of waiverJan 28, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1932351848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-238-3051",
            "fax_number": "800-246-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 APPALACHIAN PLZ",
            "city": "SOUTH WILLIAMSON",
            "state": "KY",
            "postal_code": "415039404",
            "telephone_number": "606-237-6221",
            "fax_number": "606-237-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "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": "3810015778",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100112100",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Williamson Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Williamson Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Williamson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.