DVA HEALTHCARE RENAL CARE INC – NPI #1366411381
Clinic/Center

DVA HEALTHCARE RENAL CARE INC is an AHC clinic located in WATKINSVILLE, GA. NPPES has assigned the NPI number 1366411381 to DVA HEALTHCARE RENAL CARE INC on March 14, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was last updated on Jun 18, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DVA HEALTHCARE RENAL CARE INC below.

NPI Profile for
DVA HEALTHCARE RENAL CARE INC

NPI Number
1366411381
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DVA HEALTHCARE RENAL CARE INC
Primary location
1747 LANGFORD DR
BLDG 500
WATKINSVILLE, GA 30677-7370
Phone: (706) 583-1785 Fax: (706) 583-1943
Mailing address
5200 VIRGINIA WAY
L&C DEPT
BRENTWOOD, TN 37027-7569
Phone: Fax:
Organization Subpart
No
Authorized Official
SAMUEL WEY
VP, LICENSURE & CERTIFICATION
Phone: (615) 341-6641
Updated
Certification Date
Jun 18, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for DVA HEALTHCARE RENAL CARE INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidGA000709233E
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)
GA ESRD001066

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.