Active NPI
Dialysis Clinic Inc.
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Gainesville, FL
National Provider Identifier
1972630499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- DIALYSIS CLINIC INC.
- Practice address
- 3850 NW 83Rd St
Suite 101
Gainesville, FL 32606-5601 - Phone
- (352) 337-6021
- Fax
- (352) 337-6025
- NPI assigned
- Feb 28, 2007
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
3850 NW 83Rd St
Suite 101
Gainesville, FL 32606-5601
Mailing address
1633 Church St
Suite 500
Nashville, TN 37203-2990
Phone (615) 327-3061
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 892759600 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070502000618 | FL | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 4284541129 | Practice locations: Gainesville, FL |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- Dci University of Florida
- Overall star rating
- Ownership
- Non-profit
- Certified
- Aug 1, 2007
- Medicare certification status
- Active
- Chain
- Dialysis Clinic, Inc.
- Dialysis stations
- 12
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
National Provider Directory
National Provider Directory- Tax ID family
- Elbert P Tuttle Jr MD
Organizations with this tax ID in the same state 6
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba DCI-Gainesville East
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Gainesville, FL
- NPI 1417581810
-
dba DCI Jacksonville Mid-Town
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Jacksonville, FL
- NPI 1609360577
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Jacksonville, FL
- NPI 1053597666
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Gainesville, FL
- NPI 1225469125
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Jacksonville, FL
- NPI 1720011109
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Jacksonville, FL
- NPI 1851324339
Locations
3850 NW 83rd St
#101
Gainesville, FL 32606
Phone (352) 337-6021
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.
| Facility | Type | Role | Since |
|---|---|---|---|
| Rancho Dialysis Clinic | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Dec 24, 2003 Dec 24, 2003 |
Practitioners & affiliated clinicians
Affiliated clinicians 4
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": "1172620800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696464000000",
"number": "1972630499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 CHURCH ST",
"address_2": "SUITE 500",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372032990",
"telephone_number": "615-327-3061",
"fax_number": "615-321-3697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3850 NW 83RD ST",
"address_2": "SUITE 101",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326065601",
"telephone_number": "352-337-6021",
"fax_number": "352-337-6025"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIALYSIS CLINIC INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-28",
"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": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "892759600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.