Organization Active NPI

Cheraw Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Pablo, CA
National Provider Identifier
1396203246
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
CHERAW DIALYSIS LLC
Practice address
2415 San Pablo Dam Rd Ste 504
San Pablo, CA 94806-3906
Phone
(510) 233-2991
Fax
(510) 233-6002
NPI assigned
Mar 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

2415 San Pablo Dam Rd Ste 504
San Pablo, CA 94806-3906

Mailing address

5200 Virginia Way
Att: L&C Dept
Brentwood, TN 37027-7569

Other names 1

  • Alvarado Park Home Training Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190730003639 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 7911130513 Practice locations: San Pablo, CA

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Alvarado Park Home TrainingCCN 752512
Overall star rating
5.0 of 5
Ownership
Profit
Certified
Nov 26, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita

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 NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2167959Alvarado Park Home Training2415 San Pablo Dam Road Suite 504, Richmond, CA 94806Certificate of waiverJun 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Alvarado Park Home Training2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

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

Locations

2415 San Pablo Dam Rd
Ste 504
San Pablo, CA 94806
Phone (510) 233-2991

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1396203246",
    "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": "2415 SAN PABLO DAM RD STE 504",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063906",
            "telephone_number": "510-233-2991",
            "fax_number": "510-233-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERAW DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-18",
        "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": "Alvarado Park Home Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alvarado Park Home Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.