Wyandotte Central Dialysis LLC

Primary specialty

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

Legal business name

WYANDOTTE CENTRAL DIALYSIS LLC

Doing business as

Wyandotte Central Dialysis

Practice address

3737 State Ave
Kansas City, KS 66102-3830

Phone

(913) 233-0536

Fax

(913) 233-0903

NPI assigned

Sep 29, 2006

Last updated

Jan 2, 2024By the provider in NPPES

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

• Wyandotte Central Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Listed as

DaVita Wyandotte Central DialysisCCN 172544

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 20, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

14

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 1

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

• Renal Treatment Centers West Inc

  dba Clinton Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Clinton, OK
  • NPI 1730141078

  Member Of

  NPD member

Affiliated clinicians 1

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

• Venu Nair, MD

  • Nephrology Physician
  • Kansas City, KS
  • NPI 1184783193

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1396837803",
    "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",
            "telephone_number": "615-320-4268",
            "fax_number": "877-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 STATE AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661023830",
            "telephone_number": "913-233-0536",
            "fax_number": "913-233-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOTTE CENTRAL DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200565880A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyandotte Central Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wyandotte Central Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kansas City, KS
• Providers in Kansas City, KS by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.

Verify at the official NPI Registry.