Hummer Dialysis LLC

Primary specialty

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

Legal business name

HUMMER DIALYSIS LLC

Doing business as

Lake Mead Dialysis

Practice address

713 E Lake Mead Blvd
North Las Vegas, NV 89030-6751

Phone

(702) 642-0216

Fax

(702) 633-5128

NPI assigned

May 27, 2015

Last updated

Aug 27, 2024By the provider in NPPES

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

• Lake Mead Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Listed as

DaVita Lake Mead DialysisCCN 292553

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Jun 21, 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 Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

Locations

Affiliated clinicians 2

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

• Mark J Adaimy, M.D.

  • Nephrology Physician
  • Las Vegas, NV
  • NPI 1659467769

  Dialysis facility

  Care Compare affiliation Name & address match
• Jessie M Piceno, MD

  • Nephrology Physician
  • Las Vegas, NV
  • NPI 1578602579

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1356720023",
    "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": "713 E LAKE MEAD BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890306751",
            "telephone_number": "702-642-0216",
            "fax_number": "702-633-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMMER DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "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": "1356720023",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Mead Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Mead Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tahara S Hughes
• Hang Ying Amy Huie-Li, PHARMD,MPH,CGP,FASCP
• Jeffrey Alan Hulme, RRT
• Amanda Humber
• Humble Steps BHS
• Dyrenda Murray Humphrey, MA MFT BA PSYCHOLOGY
• Shawn Humphreys
• Kevin Hung, DC
• Anyika M Hunt
• Deshawn Hunt

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.