Desoto Dialysis LLC

Primary specialty

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

Legal business name

DESOTO DIALYSIS LLC

Doing business as

Lucas County Home Training

Practice address

2702 Navarre Ave
Ste 203
Oregon, OH 43616-3224

Phone

(419) 691-1514

Fax

(419) 691-1594

NPI assigned

Sep 16, 2011

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 2

Other names 1

• Lucas County Home Training Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

DaVita Lucas County Home TrainingCCN 362794

Ownership

Profit

Certified

Feb 13, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

1

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

  dba Parkland Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Parkland, WA
  • NPI 1881987485

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Akinfemi Samson Afolabi, M.D.

  • Nephrology Physician
  • Oregon, OH
  • NPI 1992782965
  NPD (past)

Affiliated clinicians 1

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

• Akinfemi Samson Afolabi, M.D.

  • Nephrology Physician
  • Oregon, OH
  • NPI 1992782965

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1285916106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: 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": "2702 NAVARRE AVE",
            "address_2": "STE 203",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163224",
            "telephone_number": "419-691-1514",
            "fax_number": "419-691-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-16",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-27",
        "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": "0088755",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285916106",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucas County Home Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lucas County Home Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tamara Dawson-Kynard
• James Lee Demaria, D.D.S.
• Natalie Dennen, ATC, PA-C
• Dentist in Oregon LLC
• Denise S Deppen, CRNA
• Developing Grace Foundation LLC
• Michael F Devlin, M.D.
• Dialysis Partners of Northwest Ohio, LLC (Dialysis Partners of Northwest Ohio)
• Jewel Diamond, CNP
• Tracy Dickerson, CRNA

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oregon, OH
• Providers in Oregon, OH by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.