Seminole Dialysis LLC

Primary specialty

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

Legal business name

SEMINOLE DIALYSIS LLC

Practice address

76 Highland Pavilion CT
Suite 129
Hiram, GA 30141-3170

Phone

(678) 384-1180

Fax

(678) 384-0662

NPI assigned

Jan 7, 2013

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

• West Hiram Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

DaVita West Hiram DialysisCCN 112867

Overall star rating

3.0 of 5

Ownership

Profit

Certified

May 14, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

13

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

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

Affiliated clinicians 5

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

• Harini Chittineni, MD

  • Nephrology Physician
  • Austell, GA
  • NPI 1568696870

  Dialysis facility

  Care Compare affiliation Name & address match
• Mini Gupta, MD

  • Nephrology Physician
  • Austell, GA
  • NPI 1417919796

  Dialysis facility

  Care Compare affiliation Name & address match
• Nnaemezie Emmanuel Odioemene, M.D

  • Nephrology Physician
  • Austell, GA
  • NPI 1982831616

  Dialysis facility

  Care Compare affiliation Name & address match
• Jyoti Sharma, MD

  • Nephrology Physician
  • Austell, GA
  • NPI 1447213707

  Dialysis facility

  Care Compare affiliation Name & address match
• Wahid Yazdanpanah, M.D.

  • Nephrology Physician
  • Austell, GA
  • NPI 1255527339

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1275870503",
    "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": "76 HIGHLAND PAVILION CT",
            "address_2": "SUITE 129",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413170",
            "telephone_number": "678-384-1180",
            "fax_number": "678-384-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMINOLE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003133921A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Hiram Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Hiram Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew P Schooley, D.C
• Patrick Wayne Schrepel, OD
• Jessica Lynne Schwartz, RN
• Carol J Scully, CNP
• Seat LLC
• Kelsey Sheffer
• Macaiah Sheffield, DPT
• Abdul Malik Sheikh, MD
• Jennifer Lynn Shepherd, D.C.
• Mary Ann Sheppard, LPC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hiram, GA
• Providers in Hiram, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.