Active NPI
Total Renal Care Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Tucker, GA
National Provider Identifier
1992941736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- ESRD000756
- Legal business name
- TOTAL RENAL CARE INC
- Practice address
- 4434 Hugh Howell Rd
Tucker, GA 30084-4905 - Phone
- (770) 491-7187
- Fax
- (770) 491-7192
- NPI assigned
- Dec 29, 2008
- 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
- Samuel Wey
- Title
- VP Licensure & Certification
- Phone
- (615) 341-6641
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | ESRD000756 | GA | Primary |
Addresses
Primary practice location
4434 Hugh Howell Rd
Tucker, GA 30084-4905
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 928-3545
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000619561AD | Medicaid | GA | |
| 11D1100178 | Other | GA | CLIA |
Other names 1
- Georgia Dialysis for Adolescents and Pediatrics
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D1100178 | Georgia Dialysis for Adolescents and Pediatrics | Certificate of waiver | May 31, 2027 |
National Provider Directory
National Provider DirectoryLocations
4434 Hugh Howell Rd
Tucker, GA 30084
Phone (770) 404-6613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740009600000",
"number": "1992941736",
"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": "615-928-3545",
"fax_number": "833-214-6980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4434 HUGH HOWELL RD",
"city": "TUCKER",
"state": "GA",
"postal_code": "300844905",
"telephone_number": "770-491-7187",
"fax_number": "770-491-7192"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOTAL RENAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-12-29",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A",
"authorized_official_last_name": "WEY",
"authorized_official_first_name": "SAMUEL",
"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": "ESRD000756",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000619561AD",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "11D1100178",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Georgia Dialysis for Adolescents and Pediatrics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Georgia Dialysis for Adolescents and Pediatrics",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.