CAPTREE DIALYSIS LLC NPI 1952833188

NPI Information

  • NPI: 1952833188
  • Provider Name: CAPTREE DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: SUGAR CREEK DIALYSIS
  • CLIA Number: 34D2133099
  • Address: 5100 REAGAN DRIVE
    STE 10
    CHARLOTTE, NC
    ZIP 28206
  • Phone: (704) 921-9823

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NPI Details

CAPTREE DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Charlotte, NC. CAPTREE DIALYSIS LLC NPI is 1952833188. The provider is registered as an organization entity type.
The provider Is Doing Business As Sugar Creek Dialysis.

The provider's business location address is:

5100 REAGAN DRIVE
STE 10
CHARLOTTE, NC
ZIP 28206-353
Phone: (704) 921-9823
Fax: (704) 597-2902

The provider's authorized official is John Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 34D2133099 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/28/2017 and was last updated on 9/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11952833188MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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