Fort Dialysis LLC

Primary specialty

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

License

1034DC Issued in OH

Legal business name

FORT DIALYSIS LLC

Doing business as

Massillon Community Dialysis

Practice address

2112 Lincoln Way E
Massillon, OH 44646-7034

Phone

(330) 837-7730

Fax

(330) 837-7753

NPI assigned

Apr 5, 2012

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

• Massillon Community Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

DaVita Massillon Community DialysisCCN 362789

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Mar 21, 2013

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 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Pramod Anand Bhargava, M.D.

  • Nephrology Physician
  • Canton, OH
  • NPI 1568450534

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1356607162",
    "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": "2112 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446467034",
            "telephone_number": "330-837-7730",
            "fax_number": "330-837-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "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": "OH",
            "license": "1034DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082955",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Massillon Community Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Massillon Community Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael R Foran, LPCC-S
• Brianna Marie Forchione, PT, DPT
• Tiffany F Ford
• Nichole Michelle Forrer, COTA/L
• Kelly Forrest
• Donna M Fosnight, MSW, LISW
• Tracy L Foss, LPN
• Deborah C Foster-Koch, LPCC-S, LICDC
• Kathy L Foster, RN
• Malia Simone Foster

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Massillon, OH
• Providers in Massillon, OH by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.