Renal Treatment Centers-Southeast, LP.

Primary specialty

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

Legal business name

RENAL TREATMENT CENTERS-SOUTHEAST, LP.

Doing business as

River Valley Dialysis

Practice address

3121 W 2ND CT
Russellville, AR 72801-4504

Phone

(479) 968-4687

Fax

(479) 968-2260

NPI assigned

Nov 26, 2012

Last updated

Jul 9, 2026By the provider in NPPES

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

• River Valley Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Renal Treatment Centers-Southeast, LP.

  dba Bradley County Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Warren, AR
  • NPI 1194069617

  O20151222001866

  Same enrollment

Listed as

DaVita River Valley DialysisCCN 042508

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 8, 1983

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

20

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

Renal Treatment Centers - Southeast LP137 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

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

• Renal Treatment Centers-Southeast, LP.

  dba DeGray Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Arkadelphia, AR
  • NPI 1184968604
  NPD tax ID
• Renal Treatment Centers-Southeast, LP.

  dba South Little Rock Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Little Rock, AR
  • NPI 1396178471
  NPD tax ID
• Renal Treatment Centers-Southeast, LP.

  dba Forrest City Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Forrest City, AR
  • NPI 1457673345
  NPD tax ID
• Renal Treatment Centers-Southeast, LP.

  dba South Arkansas Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • El Dorado, AR
  • NPI 1508100017
  NPD tax ID
• Renal Treatment Centers-Southeast, LP.

  dba Malvern Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockport, AR
  • NPI 1700120110
  NPD tax ID
• Renal Treatment Centers-Southeast, LP.

  dba Ouachita Valley Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Camden, AR
  • NPI 1891039210
  NPD tax ID

Locations (25 of 34)

Practitioners 7

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.

• Robert F McCrary Jr., M.D.

  • Nephrology Physician
  • Hot Springs, AR
  • NPI 1285614537
  NPD (past)
• Christopher A Hebert, MD

  • Nephrology Physician
  • Dallas, TX
  • NPI 1912966045
  NPD (past)
• Andreas Tirso Maddux, MD

  • Nephrology Physician
  • Birmingham, AL
  • NPI 1316985062
  NPD (past)
• Mario Magnone, MD

  • Hospitalist Physician
  • Fairhope, AL
  • NPI 1942254149
  NPD (past)
• Nawar E Mansour, M.D.

  • Specialist
  • Memphis, TN
  • NPI 1720077589
  NPD (past)
• David R Martin, M.D.

  • Nephrology Physician
  • Euless, TX
  • NPI 1093774127
  NPD (past)
• Zhiqiang Zhang, MD

  • Nephrology Physician
  • Dublin, GA
  • NPI 1639105620
  NPD (past)

Affiliated clinicians 3

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

• David Desoto, M.D.

  • Nephrology Physician
  • Hot Springs, AR
  • NPI 1598745846

  Dialysis facility

  Care Compare affiliation Name & address match
• Michael S Gersch, MD

  • Nephrology Physician
  • Hot Springs, AR
  • NPI 1326068867

  Dialysis facility

  Care Compare affiliation Name & address match
• Drew Courtney Heiple, M.D.

  • Nephrology Physician
  • Russellville, AR
  • NPI 1376665646

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1285978627",
    "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": "3121 W 2ND CT",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728014504",
            "telephone_number": "479-968-4687",
            "fax_number": "479-968-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-SOUTHEAST, LP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "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": "200364134",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Valley Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "River Valley Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janice Reeves, LAC
• Tami Rebecca Reeves, SLP
• Elizabeth Rehm, MS, RD, LD, CDE
• Leanna Rose Reid, OT
• Shawna R Remy, LMMT
• Renewed Life LLC
• Restored Life Services of Arkansas Inc
• Miki Deneise Reynolds, NURSE PRACTITIONER
• Nathan Taylor Reynolds
• Rebecca Reynolds

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Russellville, AR
• Providers in Russellville, AR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.