Active NPI
Isd Summit Renal Care LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Akron, OH
National Provider Identifier
1366498032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 0543DC
- Legal business name
- ISD SUMMIT RENAL CARE LLC
- Practice address
- 73 Massillon Rd
Akron, OH 44312-1028 - Phone
- (330) 733-1861
- Fax
- (330) 733-4696
- NPI assigned
- May 25, 2006
- 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 | 0543DC | OH | Primary |
Addresses
Primary practice location
73 Massillon Rd
Akron, OH 44312-1028
Mailing address
5200 Virginia Way
Att: L&C Dept
Brentwood, TN 37027-7569
Phone (615) 238-3051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2118265 | Medicaid | OH |
Other names 1
- Summit Renal Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070829000014 | OH | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 6608887617 | Practice locations: Akron, OH |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Akron, OH
- NPI 1174579775
6608887617
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Munroe Falls, OH
- NPI 1205882685
6608887617
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita Summit Renal Center
- Overall star rating
- Ownership
- Profit
- Certified
- Apr 20, 1999
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 15
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0958229 | Summit Renal Center | Certificate of waiver | Mar 14, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Davita Munroe Falls Dialysis
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Akron, OH
- NPI 1174579775
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Munroe Falls, OH
- NPI 1205882685
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Akron, OH
- NPI 1407992555
Member Of
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Pearsall, TX
- NPI 1194789859
Member Of
Locations
73 Massillon Rd
Akron, OH 44312
Phone (330) 733-1861
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710115200000",
"number": "1366498032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "ATT: L&C DEPT",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277569",
"telephone_number": "615-238-3051",
"fax_number": "800-246-8346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73 MASSILLON RD",
"city": "AKRON",
"state": "OH",
"postal_code": "443121028",
"telephone_number": "330-733-1861",
"fax_number": "330-733-4696"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ISD SUMMIT RENAL CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"last_updated": "2024-03-11",
"certification_date": "2024-03-11",
"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": "0543DC",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2118265",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Summit Renal Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Summit Renal Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.