NPIMap

Organization Active NPI

Davita Riverside LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Murrieta, CA
National Provider Identifier
1003879461
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
240000806 Issued in CA
Legal business name
DAVITA RIVERSIDE LLC
Practice address
27602 Clinton Keith Rd BLDG F
Murrieta, CA 92562-8513
Phone
(951) 679-7914
Fax
(951) 679-7693
NPI assigned
Apr 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 240000806 CA Primary

Addresses

Primary practice location

27602 Clinton Keith Rd BLDG F
Murrieta, CA 92562-8513

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
1003879461MedicaidCA

Other names 1

  • Murrieta Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040915000367 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 7810807732 Practice locations: Murrieta, CA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Murrieta DialysisCCN 052730
Overall star rating
3.0 of 5
Ownership
Profit
Certified
May 31, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
24

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0872538Murrieta Dialysis27602 Clinton Keith Rd, BLDG F, Murrieta, CA 92562Certificate of waiverMay 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Davita Riverside LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Locations

27602 Clinton Keith Rd
Ste 101
Murrieta, CA 92562

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1003879461",
    "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": "27602 CLINTON KEITH RD BLDG F",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628513",
            "telephone_number": "951-679-7914",
            "fax_number": "951-679-7693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA RIVERSIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "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": "CA",
            "license": "240000806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003879461",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Murrieta Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Murrieta Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.