Etowah Dialysis LLC

Primary specialty

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

Legal business name

ETOWAH DIALYSIS LLC

Doing business as

St. Luke's Anderson Dialysis

Practice address

3779 Nicholas St
Easton, PA 18045-5115

Phone

(484) 545-0609

NPI assigned

Mar 15, 2023

Last updated

Dec 29, 2023By the provider in NPPES

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

Sam T Wey

Title

Ao

Phone

(615) 341-6691

Specialties & licenses 1

Addresses

Other names 1

• St. Luke's Anderson Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Etowah Dialysis LLC

  dba St Luke's Tamaqua Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tamaqua, PA
  • NPI 1033687413

  2567699085

  Same PAC ID
• Etowah Dialysis LLC

  dba St Lukes Home Training

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Allentown, PA
  • NPI 1376909515

  2567699085

  Same PAC ID
• Etowah Dialysis LLC

  dba St Lukes Bethlehem Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bethlehem, PA
  • NPI 1457787715

  2567699085

  Same PAC ID
• Etowah Dialysis LLC

  dba St. Luke's Macungie Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Macungie, PA
  • NPI 1659830800

  2567699085

  Same PAC ID
• Etowah Dialysis LLC

  dba St Lukes Whitehall Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Whitehall, PA
  • NPI 1770948838

  2567699085

  Same PAC ID
• Etowah Dialysis LLC

  dba St Lukes Allentown Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Allentown, PA
  • NPI 1790111060

  2567699085

  Same PAC ID

Listed as

Davita St Lukes Anderson DialysisCCN 732514

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Sep 11, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

17

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Etowah Dialysis LLC7 organizations share this tax ID, including this one

Part of

Davita Inc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

• Etowah Dialysis LLC

  dba St Luke's Tamaqua Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tamaqua, PA
  • NPI 1033687413
  NPD tax ID
• Etowah Dialysis LLC

  dba St Lukes Home Training

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Allentown, PA
  • NPI 1376909515
  NPD tax ID
• Etowah Dialysis LLC

  dba St Lukes Bethlehem Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bethlehem, PA
  • NPI 1457787715
  NPD tax ID
• Etowah Dialysis LLC

  dba St. Luke's Macungie Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Macungie, PA
  • NPI 1659830800
  NPD tax ID
• Etowah Dialysis LLC

  dba St Lukes Whitehall Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Whitehall, PA
  • NPI 1770948838
  NPD tax ID
• Etowah Dialysis LLC

  dba St Lukes Allentown Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Allentown, PA
  • NPI 1790111060
  NPD tax ID

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Anthony Dunn, D.O.

  • Nephrology Physician
  • Bethlehem, PA
  • NPI 1407938772
  NPD (past)
• Sana Rab Akbar, M.D.

  • Nephrology Physician
  • Morgantown, WV
  • NPI 1245474303
  NPD (past)

Affiliated clinicians 2

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

• Ravi Agrawal, M.B.B.S

  • Nephrology Physician
  • Bethlehem, PA
  • NPI 1396973178

  Dialysis facility

  Care Compare affiliation Name & address match
• Jose Avila

  • Nephrology Physician
  • Allentown, PA
  • NPI 1558567875

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1386345361",
    "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": "3779 NICHOLAS ST",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455115",
            "telephone_number": "484-545-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETOWAH DIALYSIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "615-341-6691"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Anderson Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Luke's Anderson Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pasqual J Enea, D.D.S.
• Eric Schoeppner MD PC
• Ericka Koffel Nutrition, LLC
• Trisha Ann Espinosa
• Melody Luz Estevez
• Melanie R Evan-Williams, PT
• Brad Evert, DO
• Sandra L Ewing, NP
• Uzoamaka Chisom Ezeanya, M.D
• Mark Joseph Fabey, DMD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Easton, PA
• Providers in Easton, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.