Mattapan Dialysis LLC

Primary specialty

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

Legal business name

MATTAPAN DIALYSIS LLC

Doing business as

Riverdale Home Training

Practice address

5144 Riverdale Rd Ste 103
Memphis, TN 38141-0271

Phone

(901) 752-5425

Fax

(901) 752-5516

NPI assigned

Jul 26, 2019

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 names 1

• Riverdale Home Training Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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 2

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

• Dva Healthcare Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pearsall, TX
  • NPI 1194789859

  Member Of

  NPD member
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Akron, OH
  • NPI 1407992555

  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.

• Rehan Shafique, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Memphis, TN
  • NPI 1851510143
  NPD (past)

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1386298560",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5144 RIVERDALE RD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381410271",
            "telephone_number": "901-752-5425",
            "fax_number": "901-752-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTAPAN DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-26",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-08",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverdale Home Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverdale Home Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matrix
• Matrix Medical Network of Tennessee, PC
• Matrix Rehab
• Marc S Matsumura
• Anveetha Reddy Matta, MD
• Matthews Cannon Enterprise LLC
• Ashley Nicolle Matthews, M.D.
• Denise Andrews Matthews
• Gekecial Matthews
• Jamil Matthews, LCSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Memphis, TN
• Providers in Memphis, TN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.