NPIMap

Organization Active NPI

Southwest Kidney Davita Dialysis Partners LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mesa, AZ
National Provider Identifier
1265615934
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
OTC-4509 Issued in AZ
Legal business name
SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC
Practice address
10238 E Hampton Ave
Ste 108
Mesa, AZ 85209-3317
Phone
(480) 357-8009
Fax
(480) 357-0372
NPI assigned
Dec 17, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Samuel T Wey
Title
VP Licensure&Certification
Phone
(615) 341-6641

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Member of 1

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

Affiliated clinicians 3

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Mountain Vista Dialysis Center of ArizonaCCN 032619
Overall star rating
3.0 of 5
Ownership
Profit
Certified
May 7, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
24

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080929000766 AZ Part A Provider - End-Stage Renal Disease Facility (ESRD) 1456438423 Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory
Tax ID family
Southwest Kidney Davita Dialysis Partners LLC22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

10238 E Hampton Ave
Ste 108
Mesa, AZ 85209
Phone (480) 357-0366

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X OTC-4509 AZ Primary

Addresses

NPPES NPI Registry

Primary practice location

10238 E Hampton Ave
Ste 108
Mesa, AZ 85209-3317

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
417208MedicaidAZ

Other names 1

NPPES NPI Registry
  • Mountain Vista Dialysis Center of Arizona Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 19, 2026.

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773878400000",
    "number": "1265615934",
    "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": "10238 E HAMPTON AVE",
            "address_2": "STE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093317",
            "telephone_number": "480-357-8009",
            "fax_number": "480-357-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "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": "AZ",
            "license": "OTC-4509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417208",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Vista Dialysis Center of Arizona",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Vista Dialysis Center of Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.