Renal Treatment Centers Mid Atlantic Inc.

Primary specialty

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

Legal business name

RENAL TREATMENT CENTERS MID ATLANTIC INC.

Practice address

246 Friendship Cir
Beaver, PA 15009-9704

Phone

(724) 788-5643

Fax

(724) 788-5651

NPI assigned

Feb 8, 2022

Organization subpart

Yes

Parent organization

DAVITA INCAs reported in NPPES

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

Authorized official

Name

Sam T Wey

Title

Senior Director L&C Dept

Phone

(615) 341-6691

Specialties & licenses 1

Addresses

Other names 1

• Beaver Valley Dialysis Doing business as

Part of

Davita Inc

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1114671120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 FRIENDSHIP CIR",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099704",
            "telephone_number": "724-788-5643",
            "fax_number": "724-788-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS MID ATLANTIC INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2022-02-08",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SENIOR DIRECTOR L&C DEPT",
        "authorized_official_telephone_number": "615-341-6691"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaver Valley Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beaver Valley Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Mark Rafalko, M.D.
• Anna Rastatter, LCSW
• Annmarie Ray, M.D.
• Dale Reckless, PT
• Joan I Reis, LPC
• Kathryn Hankins Renne, PA-C
• Barbara Repic, RN
• Barry R Reznick, MD
• Gretchen Ricchino, LPC
• Eric S Ringer, P.T.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Beaver, PA
• Providers in Beaver, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.