DVA RENAL HEALTHCARE INC (NPI# 1629039144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629039144 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | NEWAYGO COUNTY DIALYSIS |
| Practice Address |
1317 W Main St Fremont MI 49412-1478 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 2319244535 |
| Practice Fax Number | 2319244865 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665459961 |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2019-06-25 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4511180 | 05 |
| Other Name | Type Code |
|---|---|
| Newaygo County Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629415609 | Dva Renal Healthcare Inc | Clinic/Center | 300 B 22nd St South, Birmingham, AL 35233-2209 | 2013-05-30 |
| 1164728408 | Dva Renal Healthcare Inc | Clinic/Center | 415 W Nc Hwy 54, Durham, NC 27713-7516 | 2011-02-03 |
| 1295983245 | Dva Renal Healthcare Inc | Clinic/Center | 1919 Charlotte Ave Ste 200, Nashville, TN 37203-2245 | 2008-09-03 |
| 1811171440 | Dva Renal Healthcare Inc | Clinic/Center | 300 W Broadway Ste 150, Council Bluffs, IA 51503-9077 | 2007-12-18 |
| 1881623585 | Dva Renal Healthcare Inc | Clinic/Center | 271 King St, Perth Amboy, NJ 08861-4488 | 2006-07-03 |
| 1164451852 | Dva Renal Healthcare Inc | Clinic/Center | 262 Texas Rd, Ste 101, Old Bridge, NJ 08857-4008 | 2006-07-03 |
| 1912936618 | Dva Renal Healthcare Inc | Clinic/Center | 1200 Randolph Rd, Muhlenburg Campus, Plainfield, NJ 07060-3361 | 2006-07-03 |
| 1346270782 | Dva Renal Healthcare Inc | Clinic/Center | 230 Van Sciver Pkwy, Willingboro, NJ 08046-1131 | 2006-07-03 |
| 1548299381 | Dva Renal Healthcare Inc | Clinic/Center | 29 Meridian Rd, Edison, NJ 08820-2823 | 2006-07-02 |
| 1548299373 | Dva Renal Healthcare Inc | Clinic/Center | 14-20 Prospect St, East Orange, NJ 07017-2238 | 2006-07-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DVA Renal Healthcare Inc. | 2000 16th St, Jld/secgovfin, Denver, Colorado 80202-5117 |
| Street Address |
1317 W MAIN ST |
| City | FREMONT |
| State | MI |
| Zip Code | 49412-1478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437632437 | Claire Marie J Derks | Massage Therapist | 119 North Stone Road, Fremont, MI 49412 | 2018-09-14 |
| 1730565946 | Retirement Living Management of Fremont, L.L.C. | Assisted Living Facility | 801 E. Main Street, Fremont, MI 49412 | 2015-08-11 |
| 1497136410 | James Yon | Social Worker | 3682 S Maple Island Rd, Fremont, MI 49412 | 2015-06-16 |
| 1871864090 | Cheryl Lee Kublin | Specialist | 4554 W. 48th St, Fremont, MI 49412 | 2012-01-19 |
| 1326319583 | Colleen M Rice | Occupational Therapist | 4554 W. 48th Street, Fremont, MI 49412 | 2012-01-19 |
| 1154578847 | Greenlund Enterprises, Inc | Hearing Aid Equipment | 28 Wet Sheridan Street, Fremont, MI 49412 | 2008-08-25 |
| 1225170699 | Raymond Prins IIi | Dentist | 855 N Darling, Fremont, MI 49412 | 2007-02-13 |
| 1508933789 | Charles Merle Erickson | Dentist | 16 W Sheridan, Fremont, MI 49412 | 2006-11-30 |
| 1588741300 | Christopher Callis Niquette | Dentist | 327 Apache Dr, Fremont, MI 49412 | 2006-11-01 |
| 1417041179 | Newaygo County Resa | Local Education Agency (LEA) | 4747 W. 48th Street, Fremont, MI 49412 | 2006-10-03 |
| Find all providers in zip 49412 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| 1962464388 | Dva Renal Healthcare, Inc | Clinic/Center | 1949 E 23rd Ave S, Fremont, NE 68025-2452 | 2006-04-03 |
| 1144292186 | Wellbound of Menlo Park LLC | Clinic/Center | 39510 Paseo Padre Pkwy, Suite 100, Fremont, CA 94538-4707 | 2006-02-03 |
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| 1851886592 | Fms Rochester Hills, LLC | Clinic/Center | 26400 W 12 Mile Rd Ste 112, Southfield, MI 48034-1785 | 2018-06-26 |
| 1801399753 | Kasaskia Dialysis LLC | Clinic/Center | 18001 E 10 Mile Rd Ste B, Roseville, MI 48066-3803 | 2018-03-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.