Leawood Dialysis LLC

Primary specialty

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

Legal business name

LEAWOOD DIALYSIS LLC

Practice address

640 Martin Luther King Jr Blvd Ste 100
Macon, GA 31201-3297

Phone

(478) 742-5850

Fax

(478) 742-5860

NPI assigned

Nov 3, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kidney Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Member of 1

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

• Renal Treatment Centers Mid Atlantic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goldsboro, NC
  • NPI 1174086698

  Member Of

  NPD member

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1396257010",
    "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": "640 MARTIN LUTHER KING JR BLVD STE 100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013297",
            "telephone_number": "478-742-5850",
            "fax_number": "478-742-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAWOOD DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "907820770A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kidney Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anh Hoang Le, MD
• Rachel Le
• Bridget Josephine Leary, APRN, BC
• Anna Garcia Leatherwood, FNP-C
• William Alexander Leatherwood, CRNA
• Haylee Ledden
• Amy Z Lee, DMD MSD PHD
• Darryl J Lee, DC
• Euijin Lee
• Gregory Price Lee, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.