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LAKE HALLIE DIALYSIS
NPI 1508115395
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Lake Hallie, WI

Active since September 07, 2012CLIA 52D2055431 · Waiver
2/5
Overall Rating
3636 E MELBY ST, LAKE HALLIE, WI 54729(715) 833-8512(715) 833-8534 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 3, 2024, Aug 10, 2023, Jun 7, 2022 and 3 more (6 updates tracked since 2018).

About Lake Hallie Dialysis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE HALLIE DIALYSIS (NPI 1508115395) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Lake Hallie, Wisconsin and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through March 11, 2027 and lists Samuel T Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1508115395
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameTOTAL RENAL CARE INC
Location Address3636 E MELBY STLake Hallie, WI 54729-8392
Mailing Address5200 Virginia Way, Attn: L&c DeptBrentwood, TN 37027-7569
Phone(715) 833-8512
Fax(715) 833-8534
Organization SubpartNo
Authorized OfficialSamuel T WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateSeptember 7, 2012
Last NPPES UpdateSeptember 3, 20246 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2024
✔ NPI 1508115395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
3636 E MELBY ST, Lake Hallie, WI 54729
Open in Google Maps ↗

Other Names 1

Doing Business AsLake Hallie Dialysis

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2055431

Lake Halle Dialysis · Lake Hallie, WI
Active · expires Mar 11, 2027
CLIA Number52D2055431
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateMarch 12, 2025
Certificate Expiration DateMarch 11, 2027
Laboratory DirectorDr. Somsak Tanawattanacharoen
Laboratory Phone(715) 833-8512
Laboratory LocationLake Halle Dialysis3636 E Melby St, Lake Hallie, WI 54729
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for DaVita Lake Hallie Dialysis (CMS certification number 522596), from CMS Care Compare.

DaVita Lake Hallie Dialysis

Dialysis facility · Lake Hallie, WI
2/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number522596
ESRD NetworkNetwork 11
Hemodialysis Stations12
Medicare-Certified SinceSeptember 18, 2013
Location3636 E MELBY STLake Hallie, WI 54729 · Chippewa County
Phone(715) 833-8512
Services Offered
In-center hemodialysis Peritoneal dialysis Home hemodialysis training

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Total Renal Care Inc's NPI number?

The NPI number for Total Renal Care Inc is 1508115395. It was assigned to this organization in the NPPES registry on September 7, 2012. The provider is doing business as Lake Hallie Dialysis.

Where is Total Renal Care Inc located?

Total Renal Care Inc is located at 3636 E Melby St, Lake Hallie, WI 54729. The listed phone number is (715) 833-8512.

What is Total Renal Care Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Total Renal Care Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2055431) is associated with this NPI, valid through March 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Total Renal Care Inc a Medicare-certified dialysis facility?

Yes. DaVita Lake Hallie Dialysis is a Medicare-certified dialysis facility, certified since September 18, 2013.

What quality rating does Total Renal Care Inc have?

CMS rates DaVita Lake Hallie Dialysis 2 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Total Renal Care Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Anthem Blue Cross and Blue Shield and HealthPartners and 3 other insurers list Total Renal Care Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Total Renal Care Inc was last updated on September 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.