Stallington Dialysis LLC

Primary specialty

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

Legal business name

STALLINGTON DIALYSIS LLC

Practice address

950 E Mountain Blvd
Wilkes Barre, PA 18711-0028

Phone

(570) 899-6404

NPI assigned

Feb 9, 2024

Organization subpart

Yes

Parent organization

DAVITA INCAs reported in NPPES

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

• Wilkes Barre Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Stallington Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Danville, PA
  • NPI 1992521249

  7315469590

  Same PAC ID

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

Justin Drive Dialysis2 organizations share this tax ID, including this one

Part of

Davita Inc

Other organizations with this tax ID 1

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

• Stallington Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Danville, PA
  • NPI 1992521249
  NPD tax ID

Member of 2

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

• Geisinger Pharmacy, LLC

  • Specialty Pharmacy
  • Wilkes Barre, PA
  • NPI 1346366879

  Member Of

  NPD member
• Renal Treatment Centers Mid Atlantic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goldsboro, NC
  • NPI 1174086698

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1285498261",
    "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": "950 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110028",
            "telephone_number": "570-899-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STALLINGTON DIALYSIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2024-02-09",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "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": "1044852430002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilkes Barre Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wilkes Barre Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Spencer, RN, BSN
• Cindy Lou Spock
• St. Luke'S Villa
• Jennifer Stahl
• Jill Nicole Stahl
• Anthony Stambone III, PHARMD
• Rebecca Ann Stankoski, PHD, CRNP
• Dominika Stanton, PA-C
• Jason Michael Stanton, DO
• Paul Thomas Stanziale, LSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.