{"npi":"1992767149","type":"NPI-2","status":"active","name":{"display":"Dva Healthcare Renal Care INC","other":[],"organization_name":"DVA HEALTHCARE RENAL CARE INC","authorised_official":"Samuel Wey"},"specialty":{"primary_taxonomy":"261QE0700X","primary_taxonomy_description":"End-Stage Renal Disease (ESRD) Treatment Clinic/Center","slug":"end-stage-renal-disease-esrd-treatment-clinic-center","schema_org_specialty":null,"all":[{"code":"261QE0700X","description":"End-Stage Renal Disease (ESRD) Treatment Clinic/Center","primary":true,"state":"OR","license":"170047"}]},"addresses":[{"purpose":"LOCATION","street_1":"3550 LIBERTY RD S","city":"SALEM","state":"OR","postal_code":"973025700","country_code":"US","street_2":"STE 100","phone":"5033718047","fax":"5033717455"},{"purpose":"MAILING","street_1":"5200 VIRGINIA WAY","city":"BRENTWOOD","state":"TN","postal_code":"370277569","country_code":"US","street_2":"L&C DEPT"}],"license":{"state":"OR","number":"170047"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"195875","state":"OR","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20030417000022","type_code":"00-03","type_desc":"PART A PROVIDER - END-STAGE RENAL DISEASE FACILITY (ESRD)","state":"OR","pac_id":"7517875545"}]},"enumeration_date":"2006-04-04","last_updated":"2025-04-02","_meta":{"source":"NPPES","snapshot_date":"2025-04-02","doc_url":"https://findmynpi.com/api"}}