TARA BOULEVARD DIALYSIS
NPI 1962946350
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Jonesboro, GA
Overall Rating: 1 out of 5 stars
NPI Status: Active since December 05, 2016
Contact Information
6540 TARA BLVD
STE 200
JONESBORO, GA
ZIP 30236
Phone: (770) 968-8279
Fax: (770) 968-8744
- Organization
- Clinic/Center
- End-Stage Renal Disease (ESRD) Treatment
- Accepts Insurance
- CLIA Number: 11D2124236
- CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
- CLIA Exp. Date: 01-11-2027
About TARA BOULEVARD DIALYSIS
This page provides the complete NPI Profile along with additional information for Tara Boulevard Dialysis, a provider established in Jonesboro, Georgia operating as a Clinic/center, focusing in end-stage renal disease (esrd) treatment . The healthcare provider is registered in the NPI registry with number 1962946350 assigned on December 2016. The practitioner's primary taxonomy code is 261QE0700X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Tara Boulevard Dialysis. The authorized official of this NPI record is Samuel Wey (Vp Licensure & Certification)
- NPI
- 1962946350
- Provider Legal Name
- TOTAL RENAL CARE INC
- Other Organization Name
- TARA BOULEVARD DIALYSIS
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 6540 TARA BLVD STE 200 JONESBORO, GA 30236
- Location Phone
- (770) 968-8279
- Location Fax
- (770) 968-8744
- Mailing Address
- 5200 VIRGINIA WAY L&C DEPT BRENTWOOD, TN 37027
- Mailing Phone
- (615) 320-4268
- Mailing Fax
- (770) 968-8744
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-05-2016
- Last Update Date
- 02-22-2024
- Code Navigator
According to the Dialysis Facility Compare program data, Tara Boulevard Dialysis has a much below average overall quality rating based on the patient's quality of care based on data that dialysis centers report to Medicare. The Quality of Patient Star Rating for this facility is 1 out of 5 stars.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center End-Stage Renal Disease (ESRD) Treatment
- Taxonomy Code
- 261QE0700X
- Type
- Ambulatory Health Care Facilities
- License State
- GA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze Classic 4700 (Select) - HMO
- Bronze Classic PCP Saver (Select) - HMO
- Bronze Classic Standard (Select) - HMO
- Gold Classic (Select) - HMO
- Gold Classic Standard (Select) - HMO
- Gold Elite Saver Plus (Select) - HMO
- Secure (Select) - HMO
- Silver Classic Standard (Select) - HMO
- Silver Elite Saver Plus (Select) - HMO
- Silver Simple Chronic Care CKM (Select) - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with Atrium Health - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with Atrium Health - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with Atrium Health - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with Atrium Health - HMO
- Gold Elite Saver Plus - HMO
- Gold Elite Saver Plus | with Atrium Health - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 (Select) - HMO
- Bronze Classic PCP Saver Plus Rx Copay (Select) - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard (Choice) - HMO
- Bronze Classic Standard (Select) - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard (Choice) - HMO
- Bronze Classic - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 - PPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard - PPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Elite + PCP Saver - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus - PPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Silver Classic Standard - EPO
- Silver Elite - EPO
- Silver Simple Chronic Care CKM - EPO
- Bronze Classic PCP Saver - HMO
- Bronze Classic Standard - HMO
- Bronze Simple HSA - HMO
- Gold Classic Standard - HMO
- Gold Elite - HMO
- Gold Elite Saver Plus - HMO
- Secure - HMO
- Silver Classic Standard - HMO
- Silver Elite Saver Plus - HMO
- Silver Simple Chronic Care CKM - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 003190972A | MEDICAID (05) | GA |
Dialysis Facility Compare Information
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2124236
- Facility Type
- End Stage Renal Disease Dialysis Facility
- Certificate Effective Date
- January 12, 2025
- Certificate Expiration Date
- January 11, 2027
- Laboratory Director
- SABA KHAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Tara Boulevard Dialysis to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for TARA BOULEVARD DIALYSIS
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 6 | 2 | 9 | 4 | 6 | 3 | 5 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 12 | 2 | 18 | 4 | 12 | 3 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 1 + 2 + 2 + 1 + 8 + 4 + 1 + 2 + 3 + 1 + 0 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1962946350 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1962946350, enumerated as an "organization" on December 05, 2016.
The provider is located at 6540 TARA BLVD STE 200 JONESBORO, GA 30236 and the phone number is (770) 968-8279.
Clinic/Center with taxonomy code 261QE0700X and a focus in End-Stage Renal Disease (ESRD) Treatment.
The provider might be accepting Accepts: Oscar Health Insurance, Oscar Health Plan of North. Please consult your insurance carrier or call the provider to verify.
