Active NPI
Renal Treatment Centers Mid Atlantic Inc
Doing business as East Evansville Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Evansville, IN
National Provider Identifier
1326584103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- RENAL TREATMENT CENTERS MID ATLANTIC INC
- Doing business as
- East Evansville Dialysis
- Practice address
- 1312 Professional Blvd
Evansville, IN 47714-8007 - Phone
- (812) 491-6300
- Fax
- (812) 401-7554
- NPI assigned
- Jan 17, 2017
- Last updated
- Dec 30, 2025
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | NU | Primary |
Addresses
Primary practice location
1312 Professional Blvd
Evansville, IN 47714-8007
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300015256 | Medicaid | IN |
Other names 1
- East Evansville Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170508000771 | IN | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 4587572383 | Practice locations: Evansville, IN |
National Provider Directory
National Provider Directory- Tax ID family
- Renal Treatment Centers - Mid-Atlantic Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484611200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767052800000",
"number": "1326584103",
"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": "1312 PROFESSIONAL BLVD",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477148007",
"telephone_number": "812-491-6300",
"fax_number": "812-401-7554"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RENAL TREATMENT CENTERS MID ATLANTIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-01-17",
"last_updated": "2025-12-30",
"certification_date": "2025-12-30",
"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": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300015256",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "East Evansville Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "East Evansville Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.