Taskett Dialysis LLC

Primary specialty

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

Legal business name

TASKETT DIALYSIS LLC

Practice address

8021 Philips Hwy
Ste 15
Jacksonville, FL 32256-7460

Phone

(904) 636-9652

Fax

(904) 636-9657

NPI assigned

Jan 31, 2019

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

• Philips Highway Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Member of 3

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

• Florida Kidney & Hypertension Clinic Inc

  • Nephrology Physician
  • Orange Park, FL
  • NPI 1982878450

  Member Of

  NPD member
• Jacksonville Kidney Center LLC

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1255647491

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1043775331",
    "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": "8021 PHILIPS HWY",
            "address_2": "STE 15",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567460",
            "telephone_number": "904-636-9652",
            "fax_number": "904-636-9657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TASKETT DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "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": "105053100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philips Highway Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Philips Highway Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Danielle Tartal
• Shane Randall Tartt, MD
• Candra Tarver
• Willean Tarver
• David John Taska
• Maryann Tasong
• Mehmet Tatari, MD
• Claude Tate Jr.
• Hillary Tate
• Lindsey Shea Tate, PHARMD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.