Total Renal Care Inc

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

ERD-0164 Issued in SC

Legal business name

TOTAL RENAL CARE INC

Doing business as

Goose Creek Dialysis

Practice address

109 Greenland Dr
Goose Creek, SC 29445-5354

Phone

(843) 377-1199

Fax

(843) 377-1262

NPI assigned

Apr 4, 2006

Organization subpart

No

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

Addresses

Other identifiers 2

Other names 1

• Goose Creek Dialysis Doing business as

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1942262076",
    "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": "109 GREENLAND DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455354",
            "telephone_number": "843-377-1199",
            "fax_number": "843-377-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "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": "SC",
            "license": "ERD-0164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42D1025040",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ERD164",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goose Creek Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Goose Creek Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roger Dale Tinley Jr., LICENSED OPTICIAN
• To the Stars Counseling, LLC
• John Christopher Toler, D.C.
• Jessie Tomasello, RBT
• Emma R Torres, OWNER
• Total Renal Care Inc. (Goose Creek Dialysis)
• Calvin Khang Dinh Tran, DO
• Vu Nguyen Tran, DMD
• Leah S Trantham, MD
• Anna Harper Tucker, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.