NPIMap

Organization Active NPI

Southwest Kidney Davita Dialysis Partners LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1013190792
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
OTC-4430 Issued in AZ
Legal business name
SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC
Practice address
337 E Coronado Rd
Ste 101
Phoenix, AZ 85004-1582
Phone
(602) 253-9006
Fax
(602) 253-9465
NPI assigned
Dec 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 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 OTC-4430 AZ Primary

Addresses

Primary practice location

337 E Coronado Rd
Ste 101
Phoenix, AZ 85004-1582

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
361281MedicaidAZ

Other names 1

  • Phoenix Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080402000873 AZ Part A Provider - End-Stage Renal Disease Facility (ESRD) 1456438423 Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Phoenix Dialysis CenterCCN 032611
Overall star rating
1.0 of 5
Ownership
Profit
Certified
Aug 8, 2006
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.

National Provider Directory

National Provider Directory
Tax ID family
Southwest Kidney Davita Dialysis Partners LLC22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Member of 1

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

Locations

337 E Coronado Rd
Ste 101
Phoenix, AZ 85004
Phone (602) 253-9006

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779235200000",
    "number": "1013190792",
    "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": "337 E CORONADO RD",
            "address_2": "STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041582",
            "telephone_number": "602-253-9006",
            "fax_number": "602-253-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "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": "AZ",
            "license": "OTC-4430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361281",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenix Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.