Rancho Dialysis LLC

Primary specialty

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

Legal business name

RANCHO DIALYSIS LLC

Doing business as

Dover Community Dialysis

Practice address

899 E Iron Ave
Dover, OH 44622-2097

Phone

(330) 364-6309

Fax

(330) 364-6490

NPI assigned

Dec 10, 2009

Last updated

Oct 14, 2026By 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

• Dover Community Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

DaVita Dover Community DialysisCCN 362765

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 1, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

16

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 2

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
• Total Renal Care, Inc.

  dba Bountiful Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bountiful, UT
  • NPI 1184387516

  Member Of

  NPD member

Locations

Affiliated clinicians 3

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

• Anthony Joseph Degenhard, D.O.

  • Nephrology Physician
  • Canton, OH
  • NPI 1790781193

  Dialysis facility

  Care Compare affiliation Name & address match
• Kevin J Kelley, M.D.

  • Nephrology Physician
  • Canton, OH
  • NPI 1982600979

  Dialysis facility

  Care Compare affiliation Name & address match
• Dayanand Makey, MD

  • Nephrology Physician
  • Canton, OH
  • NPI 1760788368

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1225367873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: 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": "899 E IRON AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222097",
            "telephone_number": "330-364-6309",
            "fax_number": "330-364-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3118156",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dover Community Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dover Community Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Mark Pruni III, DC
• Samantha Quillen, CNP
• Annabelle Raber
• Karenann Edith Rader, BGS
• Radiology and Imaging Services, Inc
• Richard A Ransom, DPM
• RC Hastedt MD Inc
• Wendy M Read, APRN.CNP. PMHNP-BC
• Regional Medical Care, Inc.
• Relieving Hands Massage & Bee Fit

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Dover, OH
• Providers in Dover, OH by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ohio

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