DVA HEALTHCARE SOUTHWEST OHIO LLC (NPI# 1720042096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720042096 |
| Entity Type | Organization |
| Organization Name | DVA HEALTHCARE SOUTHWEST OHIO LLC |
| Other Organization Name | FAIRFIELD DIALYSIS |
| Practice Address |
1210 Hicks Blvd Fairfield OH 45014-1921 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 5139391110 |
| Practice Fax Number | 5139391202 |
| Mailing Telephone | 6152383051 |
| Mailing Fax Number | 8002468346 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-06-17 |
| Authorized Official Name | JOHN D WINSTEL JR. (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| 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 |
0491DC | OH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 3900031000 | 05 |
| Other Name | Type Code |
|---|---|
| Fairfield Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699739789 | Dva Healthcare Southwest Ohio LLC | Clinic/Center | 6550 Winton Rd, Cincinnati, OH 45224-1327 | 2006-04-14 |
| 1427012764 | Dva Healthcare Southwest Ohio LLC | Clinic/Center | 3497 S Dixie Hwy, Franklin, OH 45005-5717 | 2006-04-13 |
| 1588628846 | Dva Healthcare Southwest Ohio LLC | Clinic/Center | 10600 Mckinley Rd, Blue Ash, OH 45242-3716 | 2006-04-13 |
| 1255395455 | Dva Healthcare Southwest Ohio LLC | Clinic/Center | 2109 Reading Rd, Cincinnati, OH 45202 | 2006-04-14 |
| 1245294412 | Dva Healthcare Southwest Ohio LLC | Clinic/Center | 3267 Westbourne Dr, Cincinnati, OH 45248 | 2006-04-14 |
| Street Address |
1210 HICKS BLVD |
| City | FAIRFIELD |
| State | OH |
| Zip Code | 45014-1921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477018810 | Bullock Dialysis LLC | Clinic/Center | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2019-02-08 |
| 1861438657 | Sharad Goel | Internal Medicine | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2006-06-21 |
| 1598708612 | Frank J Albers | Internal Medicine | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2006-06-14 |
| 1184688459 | Dva Renal Healthcare Inc | Clinic/Center | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326526872 | Megan Coleen Hamill | Registered Nurse | 6570 Sosna Drive, Fairfield, OH 45014 | 2018-08-06 |
| 1831695642 | James Grant Walther | Contractor | 16408 Jeanie Drive, Aurora, IN 45014 | 2018-04-02 |
| 1104339837 | Tamara Rochester | Registered Nurse | 5474 Yellowstone Dr, Fairfield, OH 45014 | 2017-11-16 |
| 1104335892 | Barbara Johnson | Registered Nurse | 2853 Saturn Drive, Fairfield, OH 45014 | 2017-09-25 |
| 1205373537 | Samuel E Ghee IIi | Counselor | Decoach Rehabilitation Center, 6570 Sosna Drive, Fairfield, OH 45014 | 2017-01-25 |
| 1669916789 | Lacretia Ancona | In Home Supportive Care | 700 Wessel Dr #181505, Fairfield, OH 45014 | 2016-12-08 |
| 1134676299 | Lynne Mutuku | Licensed Practical Nurse | 3975 Woodridge Blvd, Apt 10, Fairfield, OH 45014 | 2016-09-07 |
| 1104291020 | Mimi Supportive Hands .llc | Home Health | 6 Ridge Dr Apt 203, Cincinnati, OH 45014 | 2015-12-03 |
| 1215319181 | Brittany Beck | Social Worker | 3050 Mack Rd Ste 205, Fairfield, OH 45014 | 2015-06-26 |
| 1093193278 | Ashli Tanner | Specialist/Technologist | 8790 N. Gilmore Rd., Fairfield, OH 45014 | 2015-05-08 |
| Find all providers in zip 45014 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942622311 | Goza Dialysis LLC | Clinic/Center | 3825 Kraus Ln Ste S, Fairfield, OH 45014-5867 | 2014-01-20 |
| 1902228513 | Dialysis Clinic Inc | Clinic/Center | 205 Ridge Rd, Fairfield, ME 04937-3376 | 2014-01-16 |
| 1790106300 | Harmony Dialysis LLC | Clinic/Center | 1800 N Texas Street, Fairfield, CA 94533-4441 | 2013-12-27 |
| 1558524512 | Total Renal Care Inc | Clinic/Center | 427 Stillson Rd, Fairfield, CT 06824-3153 | 2008-07-09 |
| 1144490178 | Southeastern Renal Dialysis L.c. | Clinic/Center | 2000 A S Main St, Fairfield, IA 52556 | 2008-03-05 |
| 1073796421 | Liberty Dialysis - Fairfield LLC | Clinic/Center | 500 Kings Hwy, Fairfield, CT 06825-4847 | 2007-12-07 |
| 1457463291 | Nna of Alabama, Inc. | Clinic/Center | 6508 Ej Oliver Blvd, Fairfield, AL 35064-1826 | 2006-08-31 |
| 1467567206 | Everest Healthcare Ohio, Inc. | Clinic/Center | 4750 Dixie Hwy, Fairfield, OH 45014-1848 | 2006-08-20 |
| 1396704771 | Renal Treatment Centers California Inc | Clinic/Center | 4660 Central Way, Fairfield, CA 94534-1803 | 2006-03-22 |
| 1477018810 | Bullock Dialysis LLC | Clinic/Center | 1210 Hicks Blvd, Fairfield, OH 45014-1921 | 2019-02-08 |
| Find all providers in FAIRFIELD | ||||
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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.