Dca of Central Valdosta LLC

Primary specialty

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

Legal business name

DCA OF CENTRAL VALDOSTA LLC

Doing business as

U S Renal Care Central Valdosta Dialysis

Practice address

506 N Patterson St
Valdosta, GA 31601-4608

Phone

(229) 219-0099

Fax

(229) 219-7331

NPI assigned

Apr 7, 2006

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

U S RENAL CARE INCAs reported in NPPES

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

Authorized official

Name

Mr. Thomas L. Weinberg

Title

Vice President & Secretary

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• U S Renal Care Central Valdosta Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Part of

US Renal Care Inc

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michaela Hagy, FNP

  • Family Nurse Practitioner
  • Adel, GA
  • NPI 1902545585
  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1982667408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19119",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036601",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316014608",
            "telephone_number": "229-219-0099",
            "fax_number": "229-219-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DCA OF CENTRAL VALDOSTA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U S RENAL CARE INC",
        "enumeration_date": "2006-04-07",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "214-736-2700",
        "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA MEDICAL CENTER",
            "identifier": "112699",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000895309E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U S Renal Care Central Valdosta Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Loving Dawson, FNP-C
• Shakierra Dawson
• Steven Brian Dawson, M.D.
• Daniel Day
• Mary T Dazey, CNM
• Dca of So Ga LLC (U S Renal Care South Georgia Dialysis)
• Ashley De Plato
• Alysha Deal, PT, DPT
• Brandon Dean, PTA
• Raymond Dean, LPC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Valdosta, GA
• Providers in Valdosta, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.