Gallatin Dialysis LLC

Primary specialty

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

Legal business name

GALLATIN DIALYSIS LLC

Doing business as

Cardinal Dialysis

Practice address

22 Grandview Plaza
Shopping Center
Florissant, MO 63033-6105

Phone

(314) 949-3462

Fax

(314) 949-3492

NPI assigned

Sep 2, 2021

Last updated

Sep 26, 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 names 1

• Cardinal Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Listed as

DaVita Cardinal DialysisCCN 262704

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Jul 27, 2022

Chain

DaVita

Dialysis stations

12

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 Stonecrest Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockford, IL
  • NPI 1518276955

  Member Of

  NPD member

Affiliated clinicians 1

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

• Christian C Nwankwo, MD

  • Nephrology Physician
  • Saint Louis, MO
  • NPI 1679772198

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1225706484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 GRANDVIEW PLAZA",
            "address_2": "SHOPPING CENTER",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336105",
            "telephone_number": "314-949-3462",
            "fax_number": "314-949-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLATIN DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardinal Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cardinal Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Omolara Fyle Thorpe
• G.a.P. Care
• Rosemary Gaertner, NP
• Gaiter CDS Homecare LLC
• Sharon S Gallagher, P.T.
• Bradley Gamache, OD
• McKenzie Rein Gamache
• Sandra L Gamby-Carey, O.T.A.
• Hannah Gansner
• Kelly Gant, C.O.T.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florissant, MO
• Providers in Florissant, MO by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missouri

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