Cheraw Dialysis LLC

Primary specialty

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

Legal business name

CHERAW DIALYSIS LLC

Practice address

3380 San Pablo Dam Rd Ste C-D
San Pablo, CA 94803-7218

Phone

(510) 262-9230

Fax

(510) 262-9203

NPI assigned

Feb 19, 2014

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 2

Other names 1

• El Sobrante Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Cheraw Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Pablo, CA
  • NPI 1396203246

  7911130513

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Alvarado Park Home Training2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cheraw Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Pablo, CA
  • NPI 1396203246
  NPD tax ID

Member of 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1124443791",
    "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": "3380 SAN PABLO DAM RD STE C-D",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948037218",
            "telephone_number": "510-262-9230",
            "fax_number": "510-262-9203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERAW DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "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": "112443791",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "550003151",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "El Sobrante Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "El Sobrante Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fanny Chen, RD, CDCES
• Henry Albert Chen, M.D.
• Linda Chen, PHARMD
• William Wei Ming Chen, MD
• Shirley Cheney, LCSW
• Cheraw Dialysis LLC
• Child Therapy Institute of Marin
• Kwang Poung Chiu, M.D.
• Heeyoung Cho, PHARM.D.
• Nathalie Chow

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in San Pablo, CA
• Providers in San Pablo, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.