Latrobe Dialysis LLC

Primary specialty

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

License

158 Issued in TN

Legal business name

LATROBE DIALYSIS LLC

Doing business as

TN Smokie Mountain Dialysis

Practice address

2320 Knob Creek Rd Ste 408
Johnson City, TN 37604-2581

Phone

(423) 232-1969

Fax

(423) 232-0320

NPI assigned

Jan 3, 2012

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

• TN Smokie Mountain Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

DaVita TN Smokie Mountain Dialysis PDCCN 442668

Overall star rating

5.0 of 5

Ownership

Profit

Certified

Mar 8, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

2

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

CLIA laboratory certificates

Member of 1

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

• Total Renal Care, Inc.

  dba Walker South Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Walker, LA
  • NPI 1841682200

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stanley Eugene Vermillion, MD

  • Nephrology Physician
  • Johnson City, TN
  • NPI 1699779629
  NPD (past)

Affiliated clinicians 2

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

• Lara Wahib Kfoury, MD

  • Nephrology Physician
  • Johnson City, TN
  • NPI 1700074416

  Dialysis facility

  Care Compare affiliation Name & address match
• Martin Quan Tran, DO

  • Nephrology Physician
  • Johnson City, TN
  • NPI 1851395891

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1184994576",
    "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": "2320 KNOB CREEK RD STE 408",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042581",
            "telephone_number": "423-232-1969",
            "fax_number": "423-232-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATROBE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "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": "TN",
            "license": "158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442668",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TN Smokie Mountain Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TN Smokie Mountain Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian Patrick Larsen Wells
• Jack Larsen
• Margaret A Lassiter, PHARMD
• Daniel Latham, LPC/MHSP
• Tido A Latour, CRNA
• Whitney Charlena Lau, MS, CCC-SLP
• Megan Rae Laughters, RRT
• Lauren Sineath Rd LDN
• Steven R Lawhon, PSY.D.
• Nicole Ann Lawitzke, CRNA

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Johnson City, TN
• Providers in Johnson City, TN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; 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.