Pinewoods Dialysis LLC

Primary specialty

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

Legal business name

PINEWOODS DIALYSIS LLC

Practice address

12201 W 110TH St
Overland Park, KS 66210-4045

Phone

(913) 451-5984

Fax

(913) 327-5401

NPI assigned

Dec 11, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Overland Park Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Listed as

DaVita Overland Park DialysisCCN 172571

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Jul 12, 2018

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

Tax ID family

Emporia Dialysis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pinewoods Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Emporia, KS
  • NPI 1801205570
  NPD tax ID

Member of 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Affiliated clinicians 5

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

• Achal K Desai, M.D.

  • Nephrology Physician
  • Shawnee, KS
  • NPI 1134123185

  Dialysis facility

  Care Compare affiliation Name & address match
• Kristine Herron, MD

  • Nephrology Physician
  • Olathe, KS
  • NPI 1750440848

  Dialysis facility

  Care Compare affiliation Name & address match
• Richard A Schumacher, DO

  • Nephrology Physician
  • Olathe, KS
  • NPI 1275692295

  Dialysis facility

  Care Compare affiliation Name & address match
• Suleiman Daifallah, M.D.

  • Nephrology Physician
  • North Kansas City, MO
  • NPI 1982897682

  Dialysis facility

  Care Compare affiliation Name & address match
• Archana Goel, MD

  • Nephrology Physician
  • Kansas City, MO
  • NPI 1679684690

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1265947477",
    "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": "12201 W 110TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104045",
            "telephone_number": "913-451-5984",
            "fax_number": "913-327-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEWOODS DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004611340001",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overland Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Pierce, LCPC
• Pierre W Keitges MD PC
• Robert L Pierron, M.D.
• George B Pierson, MD
• Amber Nicole Pihl, PHARMD
• Jennifer Ann Pinker York, LSCSW, LCSW
• Lacee Pinkerton, RD
• Mark Clifford Pinkerton, M.D.
• Riley Pinks
• Pinnacle Home Staging of Nwa LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Overland Park, KS
• Providers in Overland Park, KS by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kansas

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