Dawson Dialysis LLC

Primary specialty

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

Legal business name

DAWSON DIALYSIS LLC

Practice address

587 N Mountain Ave
Upland, CA 91786-5016

Phone

(909) 931-4515

Fax

(909) 981-5086

NPI assigned

Jan 22, 2015

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita Upland Colonies DialysisCCN 552813

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Apr 6, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

25

Member of 1

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

• Total Renal Care Inc

  dba Cascade Dialysis

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

  Member Of

  NPD member

Affiliated clinicians 3

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

• Mary Phuong Bui

  • Nephrology Physician
  • Upland, CA
  • NPI 1841225224

  Dialysis facility

  Care Compare affiliation Name & address match
• Minna F Huang, M.D.

  • Nephrology Physician
  • Upland, CA
  • NPI 1841447745

  Dialysis facility

  Care Compare affiliation Name & address match
• Chirag Vaidya, MD

  • Nephrology Physician
  • Upland, CA
  • NPI 1073654570

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1316336753",
    "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",
            "telephone_number": "615-238-3085",
            "fax_number": "800-264-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865016",
            "telephone_number": "909-931-4515",
            "fax_number": "909-981-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWSON DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "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": "1316336753",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Davis-Bates, FNP
• Constance Alice Davis, MFCC
• Dale L Davis, M.D.
• Josh-Shua Davis, BA
• Dawn M Terashita, PC
• Theresa Dawson
• Decerie Baculi Dayag, MD
• Daystar Medical Corporation (Foothill Medical Clinic)
• Michelle Angela Dazalla, LMFT
• Tiffany De Jesus

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Upland, CA
• Providers in Upland, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.