Pible Dialysis LLC

Primary specialty

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

License

12V397 Issued in CO

Legal business name

PIBLE DIALYSIS LLC

Doing business as

West Lakewood Dialysis

Practice address

11700 W 2ND PL
Ste 325
Lakewood, CO 80228

Phone

(303) 987-4672

Fax

(303) 987-4687

NPI assigned

Apr 4, 2014

Last updated

Jul 11, 2024By the provider in NPPES

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

• West Lakewood Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

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).

• Pible Dialysis LLC

  dba Sable Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Aurora, CO
  • NPI 1750632592

  2264689264

  Same PAC ID

Tax ID family

Pible Dialysis LLC2 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.

• Pible Dialysis LLC

  dba Sable Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Aurora, CO
  • NPI 1750632592
  NPD tax ID

Member of 1

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

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1134547383",
    "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": "11700 W 2ND PL",
            "address_2": "STE 325",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80228",
            "telephone_number": "303-987-4672",
            "fax_number": "303-987-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIBLE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-04",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "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": "CO",
            "license": "12V397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134547383",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Lakewood Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Lakewood Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Lakewood, CO
• Providers in Lakewood, CO by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.