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SOUTH CHARLOTTE DIALYSIS
NPI 1720047301
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Charlotte, NC

Active since March 21, 2006CLIA 34D0655324 · Waiver
5/5
Overall Rating
10504 PARK RD, CHARLOTTE, NC 28210(980) 399-4784(980) 399-4817 Get Directions Write a Review

NPPES record last updated: January 23, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 12, 2023, Sep 8, 2020, May 20, 2020 and 1 more (4 updates tracked since 2018).

About South Charlotte Dialysis NPPES

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

SOUTH CHARLOTTE DIALYSIS (NPI 1720047301) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Charlotte, North Carolina and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Samuel T Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1720047301
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameDVA HEALTHCARE RENAL CARE INC
Location Address10504 PARK RDCharlotte, NC 28210-8405
Mailing Address5200 Virginia Way, Att: L&c DeptBrentwood, TN 37027-7569 · (615) 320-4593 · Fax (800) 293-5872
Phone(980) 399-4784
Fax(980) 399-4817
Organization SubpartNo
Authorized OfficialSamuel T WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateMarch 21, 2006
Last NPPES UpdateJanuary 23, 20244 updates tracked since enumeration
NPPES CertifiedJanuary 22, 2024
✔ NPI 1720047301 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
10504 PARK RD, Charlotte, NC 28210
Open in Google Maps ↗

Other Names 1

Doing Business AsSouth Charlotte Dialysis

Other Identifiers 2

MedicaidNDC002SC
Medicaid3412523NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee 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 34D0655324

South Charlotte Dialysis · Charlotte, NC
Active · expires Aug 31, 2026
CLIA Number34D0655324
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorChris N. Fotiadis
Laboratory Phone(980) 399-4784
Laboratory LocationSouth Charlotte Dialysis10504 Park Road, Charlotte, NC 28210
CLIA data matches this NPI record on: Address Name 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 South Charlotte Dialysis (CMS certification number 342523), from CMS Care Compare.

DaVita South Charlotte Dialysis

Dialysis facility · Charlotte, NC
5/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number342523
ESRD NetworkNetwork 6
Hemodialysis Stations23
Medicare-Certified SinceAugust 4, 1986
Location10504 PARK RDCharlotte, NC 28210 · Mecklenburg County
Phone(980) 399-4784
Services Offered
In-center hemodialysis

Patient Survey Results

Nephrologists’ communication and caring
Patients who reported their kidney doctors always communicated well and cared for them as a person.
54% 2/5
Dialysis center care and operations
Patients who reported center staff always communicated well, kept them as comfortable as possible, behaved professionally and kept the center clean.
57% 2/5
Providing information to patients
Patients who reported their kidney doctors and center staff gave them the information they needed to care for their health.
77% 2/5
Rating of the kidney doctors
Patients who rated their kidney doctors 9 or 10 on a scale of 0 (worst) to 10 (best).
55% 2/5
Rating of the dialysis center staff
Patients who rated the center staff 9 or 10 on a scale of 0 (worst) to 10 (best).
61% 2/5
Rating of the dialysis center
Patients who rated the dialysis center 9 or 10 on a scale of 0 (worst) to 10 (best).
68% 2/5
Percentages are patients giving the best possible responses in the In-Center Hemodialysis (ICH CAHPS) patient survey. Star ratings are assigned by CMS on a one-to-five star scale; five is the highest.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEAD MEDICAL PC.
Clinic/Center (Ambulatory Surgical)
10504 PARK RD
CHARLOTTE, NC 28210
Mecklenburg County (704) 319-9045
CHARLOTTE PAIN ASSOCIATES PA
Anesthesiology (Pain Medicine)
10504 PARK RD, SUITE 100
CHARLOTTE, NC 28210
Mecklenburg County (704) 364-7727

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 Healthcare Renal Care Inc's NPI number?

The NPI number for DVA Healthcare Renal Care Inc is 1720047301. It was assigned to this organization in the NPPES registry on March 21, 2006. The provider is doing business as South Charlotte Dialysis.

Where is DVA Healthcare Renal Care Inc located?

DVA Healthcare Renal Care Inc is located at 10504 Park Rd, Charlotte, NC 28210. The listed phone number is (980) 399-4784.

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

Yes. A Certificate of Waiver (number 34D0655324) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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

Yes. DaVita South Charlotte Dialysis is a Medicare-certified dialysis facility, certified since August 4, 1986.

What quality rating does DVA Healthcare Renal Care Inc have?

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

What insurance does DVA Healthcare Renal Care Inc accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC and 7 other insurers list DVA Healthcare 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 DVA Healthcare Renal Care Inc was last updated on January 23, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.