Ross Clark Circle Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

S3503 Issued in AL

Legal business name

ROSS CLARK CIRCLE DIALYSIS LLC

Doing business as

Wiregrass Kidney Center

Practice address

1450 Ross Clark Cir
Ste 200
Dothan, AL 36301-4770

Phone

(334) 792-8907

Fax

(334) 792-8912

NPI assigned

Jul 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Wiregrass Kidney Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Listed as

DaVita Wiregrass Kidney CenterCCN 012630

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 23, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

20

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Bainbridge Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Worth, TX
  • NPI 1699041152

  Member Of

  NPD member
• Renal Treatment Centers-Southeast, LP.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Donna, TX
  • NPI 1902353543

  Member Of

  NPD member

Locations

Networks

• AL HMO D-SNP

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Olawale Mayokun Osunsanya, M.D.

  • Nephrology Physician
  • Dothan, AL
  • NPI 1013998491

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1003070285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 ROSS CLARK CIR",
            "address_2": "STE 200",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014770",
            "telephone_number": "334-792-8907",
            "fax_number": "334-792-8912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSS CLARK CIRCLE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AL",
            "license": "S3503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003070285",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067833571A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008910100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wiregrass Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wiregrass Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rooted in Resilience Therapy Services, LLC
• Sachary Rosado Caraballo, MD
• Whitnye Robin Rose
• Amy Roselius
• Rosestone Infectious Disease Care LLC
• Ross P. Davis MD PC
• Jean Elizabeth Ross, CRNP
• Melea A Ross, AT
• Paul Curtis Roten, OD
• Jennifer Dawn Rothman, BCBA

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Dothan, AL
• Providers in Dothan, AL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.