American Fork Dialysis LLC

Primary specialty

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

Legal business name

AMERICAN FORK DIALYSIS LLC

Practice address

1175 E 50 S Ste 111
American Fork, UT 84003-2846

Phone

(801) 763-1304

Fax

(801) 763-1305

NPI assigned

Oct 25, 2007

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

• Lone Peak Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Listed as

DaVita Lone Peak DialysisCCN 462535

Overall star rating

5.0 of 5

Ownership

Profit

Certified

Jan 25, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

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 2

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

• Revere Health PC

  • Orthopaedic Surgery Physician
  • Salem, UT
  • NPI 1942233986

  Member Of

  NPD member
• Total Renal Care Inc

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

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Zachary Turley Freestone, D.O.

  • Nephrology Physician
  • American Fork, UT
  • NPI 1790070449

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1306025499",
    "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": "1175 E 50 S STE 111",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032846",
            "telephone_number": "801-763-1304",
            "fax_number": "801-763-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN FORK DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "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": "1306025499",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Peak Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lone Peak Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• American Fork Care Center LLC
• American Fork Care Center,LLC
• American Fork Chiropractic & Accident Rehabilitation P.C.
• American Fork City Corporation
• American Fork Dialysis Center
• American Fork Hospital
• American Fork Modern Dentistry, LLP
• American Fork Orthodontics PC
• American Fork Pediatrics, Inc.
• American Fork Vision Center Inc.

• All providers in American Fork, UT
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.