Dva Renal Healthcare Inc

Primary specialty

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

License

300102 Issued in KY

Legal business name

DVA RENAL HEALTHCARE INC

Practice address

400 Centre View Blvd
Crestview Hills, KY 41017-3478

Phone

(859) 341-5561

Fax

(859) 341-5746

NPI assigned

Apr 10, 2006

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

• Crestview Hills Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Listed as

DaVita Crestview Hills DialysisCCN 182529

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Feb 25, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

20

Tax ID family

Gambro Healthcare Anahe173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hopkinsville, KY
  • NPI 1184687824
  NPD tax ID
• Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hopkinsville, KY
  • NPI 1417910522
  NPD tax ID

Affiliated clinicians 3

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

• Emily Sue Kenner, M.D.

  • Nephrology Physician
  • Edgewood, KY
  • NPI 1225201858

  Dialysis facility

  Care Compare affiliation Name & address match
• Thomas Shaughnessy, M.D.

  • Nephrology Physician
  • Edgewood, KY
  • NPI 1326083379

  Dialysis facility

  Care Compare affiliation Name & address match
• R Geoffrey Motz, MD

  • Nephrology Physician
  • Cincinnati, OH
  • NPI 1851787634

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1124081252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: 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": "400 CENTRE VIEW BLVD",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173478",
            "telephone_number": "859-341-5561",
            "fax_number": "859-341-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "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": "KY",
            "license": "300102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3900019500",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestview Hills Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crestview Hills Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• DRS Haas & Wehrman PSC
• Rhianna Dunne, M.A., CF-SLP
• Lester Sherman Duplechan, M.D.
• Michael William Dusing, MD
• Sophie Duval-Austin, DMD
• Matthew J Dykhuizen, M.D.
• Jordan A Earlywine, DPT
• Brooke B Edwards, M.D.
• David Edwards, APRN, MSN, PMHNP-BC
• Shahed Elhamdani, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Crestview Hills, KY
• Providers in Crestview Hills, KY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.