NPIMap

Organization Active NPI

Renal Treatment Centers-Southeast LP

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Demopolis, AL
National Provider Identifier
1285046979
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RENAL TREATMENT CENTERS-SOUTHEAST LP
Practice address
505 US Highway 80 W Ste F
Demopolis, AL 36732-4148
Phone
(334) 287-1254
Fax
(334) 287-1166
NPI assigned
May 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

505 US Highway 80 W Ste F
Demopolis, AL 36732-4148

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
180497MedicaidAL

Other names 1

  • White Bluff Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151113002493 AL Part A Provider - End-Stage Renal Disease Facility (ESRD) 1658555255 Practice locations: Demopolis, AL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita White Bluff DialysisCCN 012679
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Nov 24, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2080442White Bluff Dialysis505 US Highway 80 W Suite F, Demopolis, AL 36732Certificate of waiverJul 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Degray Dialysis137 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1285046979",
    "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": "505 US HIGHWAY 80 W STE F",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367324148",
            "telephone_number": "334-287-1254",
            "fax_number": "334-287-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-SOUTHEAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "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": "180497",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Bluff Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "White Bluff Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Demopolis, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.