NPIMap

Organization Active NPI

Captree Dialysis LLC

Doing business as Sugar Creek Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
National Provider Identifier
1952833188
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
CAPTREE DIALYSIS LLC
Doing business as
Sugar Creek Dialysis
Practice address
5100 Reagan Drive
Ste 10
Charlotte, NC 28206-1353
Phone
(704) 921-9823
Fax
(704) 597-2902
NPI assigned
Mar 28, 2017
Last updated
Sep 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

5100 Reagan Drive
Ste 10
Charlotte, NC 28206-1353

Mailing address

5200 Virginia Way
L & C Department
Brentwood, TN 37027-7569
Phone (615) 320-4593

Other identifiers 1

IdentifierTypeStateIssuer
1952833188MedicaidNC

Other names 1

  • Sugar Creek Dialysis Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1952833188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4593",
            "fax_number": "800-293-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 REAGAN DRIVE",
            "address_2": "STE 10",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282061353",
            "telephone_number": "704-921-9823",
            "fax_number": "704-597-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPTREE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "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": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952833188",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sugar Creek Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sugar Creek Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.