NPIMap

Organization Active NPI

Dialysis Clinic Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Redding, CA
National Provider Identifier
1942229182
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
License
110000523 Issued in CA
Legal business name
DIALYSIS CLINIC INC.
Practice address
180 Northpoint Dr
Redding, CA 96003-2510
Phone
(530) 246-1140
Fax
(530) 246-1128
NPI assigned
Jul 19, 2006
Last updated
Oct 5, 2023By the provider in NPPES
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
Mr. Donovan Schultz
Title
President
Phone
(615) 327-3061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 110000523 CA Primary

Addresses

Primary practice location

180 Northpoint Dr
Redding, CA 96003-2510

Mailing address

180 Northpoint Dr
Redding, CA 96003-2510
Phone (530) 246-1140

Other identifiers 1

IdentifierTypeStateIssuer
CDC52537FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030604000007 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 4284541129 Practice locations: Redding, CA

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
05D1029307Dialysis Clinic Inc #219180 Northpoint Drive, Redding, CA 96003Certificate of waiverAug 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
Dialysis Clinic Inc238 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 8

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

Locations

180 Northpoint Dr
Redding, CA 96003
Phone (530) 232-3000

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": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1942229182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 NORTHPOINT DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960032510",
            "telephone_number": "530-246-1140",
            "fax_number": "530-246-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NORTHPOINT DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960032510",
            "telephone_number": "530-246-1140",
            "fax_number": "530-246-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "110000523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC52537F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.