Plattaz Dialysis, LLC

Primary specialty

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

Legal business name

PLATTAZ DIALYSIS, LLC

Practice address

100 Promenade Pkwy Ste C
Fayetteville, GA 30214-7735

Phone

(678) 788-6328

Fax

(678) 788-6351

NPI assigned

Aug 4, 2020

Organization subpart

Yes

Parent organization

DAVITA INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other names 1

• West Clayton Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

DaVita West Clayton DialysisCCN 852582

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Dec 9, 2020

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

Part of

Davita Inc

Member of 1

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

• Renal Treatment Centers Mid Atlantic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goldsboro, NC
  • NPI 1174086698

  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.

• Dariush Bahrami, MD

  • Nephrology Physician
  • Atlanta, GA
  • NPI 1659354850
  NPD (past)

Affiliated clinicians 4

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

• Dariush Bahrami, MD

  • Nephrology Physician
  • Atlanta, GA
  • NPI 1659354850

  Dialysis facility

  Care Compare affiliation Name & address match
• Dhruv Kamleshkumar Modi, MD

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1891185815

  Dialysis facility

  Care Compare affiliation Name & address match
• Vishal N Ratkalkar, M.D.

  • Nephrology Physician
  • Newnan, GA
  • NPI 1932189503

  Dialysis facility

  Care Compare affiliation Name & address match
• Muhammad Azeem Khan, M.D.

  • Internal Medicine Physician
  • Hobbs, NM
  • NPI 1316120660

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1336759463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROMENADE PKWY STE C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147735",
            "telephone_number": "678-788-6328",
            "fax_number": "678-788-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTAZ DIALYSIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2020-08-04",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Clayton Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Clayton Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Piilola
• Thomas Hugh Pinaud
• Emile C Pinera, M.D.
• Platinum Healthcare Services
• Platinum Pharmacy LLC
• Elisabeth Pleasant
• Lauren Lee Polito, D.M.D
• Yolanda Polk
• Arvind Jayaraj Ponnambalam, MD
• David Michael Popoli, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.