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

Doing business as

Glen Raven Dialysis

Practice address

2210 W Webb Ave
Burlington, NC 27217-1068

Phone

(336) 538-9820

Fax

(336) 538-9826

NPI assigned

Sep 19, 2017

Last updated

Jun 26, 2025By 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

• Glen Raven Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

DaVita Glen Raven DialysisCCN 342726

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Mar 26, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

27

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

Renal Treatment Centers - Mid-Atlantic Inc80 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

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

• Renal Treatment Centers Mid Atlantic Inc

  dba Rosewood Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goldsboro, NC
  • NPI 1174086698
  NPD tax ID
• Renal Treatment Centers Mid Atlantic Inc

  dba Alamance County Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Graham, NC
  • NPI 1215393616
  NPD tax ID
• Renal Treatment Centers Mid Atlantic Inc

  dba Downtown Durham Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Durham, NC
  • NPI 1326536327
  NPD tax ID
• Renal Treatment Centers Mid Atlantic Inc

  dba Burlington Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, NC
  • NPI 1689633224
  NPD tax ID
• Renal Treatment Centers Mid Atlantic Inc

  dba Kenly Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Kenly, NC
  • NPI 1780147207
  NPD tax ID
• Renal Treatment Centers Mid Atlantic Inc

  dba Mebane Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mebane, NC
  • NPI 1821591967
  NPD tax ID

Affiliated clinicians 1

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

• Sarath Kolluru, MD

  • Nephrology Physician
  • Burlington, NC
  • NPI 1255534004

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1184143356",
    "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": "2210 W WEBB AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272171068",
            "telephone_number": "336-538-9820",
            "fax_number": "336-538-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS MID ATLANTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "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": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184143356",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Raven Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ingle Reid
• Seanna Reid
• Sharon A. Reilly, M.D.
• Matthew Gordon Rein, M.D.
• Reliance Home Health Care Solutions
• Renal Treatment Centers Mid Atlantic Inc (Burlington Dialysis)
• Renew Hair Loss Solutions
• Residential Treatment Services
• Residential Treatment Services of Alamance
• Residential Treatment Services of Alamance, Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Burlington, NC
• Providers in Burlington, NC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.