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
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- 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, 2023
- 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
- John D Winstel
- Title
- Chief Accounting Officer
- Phone
- (253) 733-4501
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810015778 | Medicaid | WV | |
| 7100112100 | Medicaid | KY |
Other names 1
- South Williamson Dialysis
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D1094938 | South Williamson Dialysis | Certificate of waiver | Jan 28, 2027 |
National Provider Directory
National Provider DirectoryNPI 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.