Renal Center of Fort Dodge, LLC

Primary specialty

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

Legal business name

RENAL CENTER OF FORT DODGE, LLC

Doing business as

Renal Center of Fort Dodge

Practice address

117 S 25TH St
Fort Dodge, IA 50501-4357

Phone

(515) 206-6583

Fax

(515) 206-6606

NPI assigned

Aug 11, 2011

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 1

Other names 1

• Renal Center of Fort Dodge Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Listed as

DaVita Renal Center of Fort DodgeCCN 162550

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Sep 1, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

16

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 1

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

• Renal Treatment Centers Northeast Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lehighton, PA
  • NPI 1598727372

  Member Of

  NPD member

Locations

Affiliated clinicians 2

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

• Michael W Lee, MD

  • Nephrology Physician
  • Fort Dodge, IA
  • NPI 1407828718

  Dialysis facility

  Care Compare affiliation Name & address match
• Euclid Jerome St Hill, M.D.

  • Nephrology Physician
  • North Sioux City, SD
  • NPI 1740703990

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1023397718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 25TH ST",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014357",
            "telephone_number": "515-206-6583",
            "fax_number": "515-206-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL CENTER OF FORT DODGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023397718",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renal Center of Fort Dodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Real Optics Inc
• Real Transportation LLC
• Kelsey Ellen Redmond, ARNP
• Jordan Reeder, ARNP
• Regional Pathologists, P.C.
• Chad Troy Rennie, MD
• Anne-Kathrin Reuter, MS, RD, LD
• Kelli A Reuter, LMHC
• Rick Salocker DPM PC
• Leann M Rider-Hildreth, LISW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.