Dva Healthcare Renal Care, Inc.

Primary specialty

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

Legal business name

DVA HEALTHCARE RENAL CARE, INC.

Doing business as

Perry Dialysis

Practice address

118 W Main St
Perry, FL 32347-2656

Phone

(850) 584-6012

Fax

(850) 584-6040

NPI assigned

Mar 11, 2006

Last updated

Nov 29, 2022By the provider in NPPES

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Perry Dialysis Doing business as

Member of 2

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

• Dva Healthcare Renal Care Inc

  dba Charlotte Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1023077682

  Member Of

  NPD member
• Dva Renal Healthcare Inc

  dba Nashville Home Training Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Nashville, TN
  • NPI 1295983245

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1972571206",
    "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",
            "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": "118 W MAIN ST",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472656",
            "telephone_number": "850-584-6012",
            "fax_number": "850-584-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-11",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "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": "890087600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perry Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diane Dodgen, M.D.
• Dr. Joseph W. Fuller
• Lindsey Nicole Driggers, PHARM. D
• Jia Li Duan, DO
• Levette Nicole Dunbar, MD
• Laura L Early, RN
• Terri Beth Ellison, APRN
• Macy Ely, DNP, ARNP, FNP-C
• Ronald Emerick Jr., D.O.
• Nunnie Emery, ARNP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Perry, FL
• Providers in Perry, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.