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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DVA RENAL HEALTHCARE INC
NPI 1679542617
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Fayetteville, GA

Active since March 14, 2006CLIA 11D0952596 · Waiver
2/5
Overall Rating
1279 HIGHWAY 54 W STE 110, FAYETTEVILLE, GA 30214(678) 817-9974(678) 817-9930 Get Directions Write a Review

NPPES record last updated: August 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 4, 2026, Aug 15, 2024, Oct 27, 2023 and 1 more (4 updates tracked since 2021).

About Dva Renal Healthcare Inc NPPES

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

DVA RENAL HEALTHCARE INC (NPI 1679542617) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Fayetteville, Georgia and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through October 15, 2026 and lists Samuel T Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1679542617
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameDVA RENAL HEALTHCARE INC
Location Address1279 HIGHWAY 54 W STE 110Fayetteville, GA 30214-4551
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Phone(678) 817-9974
Fax(678) 817-9930
Organization SubpartNo
Authorized OfficialSamuel T WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateMarch 14, 2006
Last NPPES UpdateAugust 4, 20264 updates tracked since enumeration
NPPES CertifiedAugust 4, 2026
✔ NPI 1679542617 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
License✔ Licensed in GA · ESRD001035
1279 HIGHWAY 54 W STE 110, Fayetteville, GA 30214
Open in Google Maps ↗

Other Identifiers 2

Other11D0952596GA · Clia Waiver
Medicaid000818056AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Superior HealthPlan, Ambetter Health 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 11D0952596

Fayetteville Dialysis · Fayetteville, GA
Active · expires Oct 15, 2026
CLIA Number11D0952596
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateOctober 16, 2024
Certificate Expiration DateOctober 15, 2026
Laboratory DirectorKamyar Madani
Laboratory Phone(678) 817-9974
Laboratory LocationFayetteville Dialysis1279 Highway 54 West, Suite 110, Fayetteville, GA 30214
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 DCI Fayetteville (CMS certification number 112637), from CMS Care Compare.

DCI Fayetteville

Dialysis facility · Fayetteville, GA
2/5 CMS RatingRating period January 2020 to December 2023
OwnershipNon-profit
ChainDialysis Clinic, Inc.
CMS Certification Number112637
ESRD NetworkNetwork 6
Hemodialysis Stations23
Medicare-Certified SinceJuly 7, 1997
Location155 BRANDYWINE BOULEVARDFayetteville, GA 30214 · Fayette County
Phone(770) 716-6940
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 DVA Renal Healthcare Inc's NPI number?

The NPI number for DVA Renal Healthcare Inc is 1679542617. It was assigned to this organization in the NPPES registry on March 14, 2006.

Where is DVA Renal Healthcare Inc located?

DVA Renal Healthcare Inc is located at 1279 Highway 54 W Ste 110, Fayetteville, GA 30214. The listed phone number is (678) 817-9974.

What is DVA Renal Healthcare 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 DVA Renal Healthcare Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0952596) is associated with this NPI, valid through October 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is DVA Renal Healthcare Inc a Medicare-certified dialysis facility?

Yes. DCI Fayetteville is a Medicare-certified dialysis facility, certified since July 7, 1997.

What quality rating does DVA Renal Healthcare Inc have?

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

What insurance does DVA Renal Healthcare Inc accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Superior HealthPlan, Ambetter of Alabama and Ambetter of North Carolina and 4 other insurers list DVA Renal Healthcare 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 DVA Renal Healthcare Inc was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days 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.