NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as McDonough Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • McDonough, GA
National Provider Identifier
1952370892
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
ESRD001157 Issued in GA
Legal business name
TOTAL RENAL CARE INC
Doing business as
McDonough Dialysis Center
Practice address
114 Dunn St
McDonough, GA 30253-2347
Phone
(770) 898-4999
Fax
(770) 898-0059
NPI assigned
Mar 14, 2006
Last updated
Mar 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X ESRD001157 GA Primary

Addresses

Primary practice location

114 Dunn St
McDonough, GA 30253-2347

Mailing address

5200 Virginia Way
L&C Dept.
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
000828462AMedicaidGA

Other names 1

  • McDonough Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071031000218 GA Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: McDonough, GA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita McDonough Dialysis CenterCCN 112651
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Sep 14, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
24

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
11D0947601McDonough Dialysis Center114 Dunn Street, McDonough, GA 30253Certificate of waiverJun 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

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

View all 15

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1952370892",
    "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": "114 DUNN ST",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302532347",
            "telephone_number": "770-898-4999",
            "fax_number": "770-898-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "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": "GA",
            "license": "ESRD001157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000828462A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McDonough Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McDonough Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.