Targhee Dialysis, LLC

Primary specialty

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

Legal business name

TARGHEE DIALYSIS, LLC

Practice address

1550 Goodman Ave
Cincinnati, OH 45224-1005

Phone

(513) 538-3768

Fax

(513) 538-3769

NPI assigned

Nov 20, 2020

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

Samuel T Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other names 1

• College Hill Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Targhee Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cincinnati, OH
  • NPI 1083184451

  0042559262

  Same PAC ID

Listed as

DaVita College Hill DialysisCCN 362898

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Jun 17, 2021

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

College Hill Dialysis2 organizations share this tax ID, including this one

Part of

Davita Inc

Other organizations with this tax ID 1

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

• Targhee Dialysis, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cincinnati, OH
  • NPI 1083184451
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elisha Lancaster, MD

  • Nephrology Physician
  • Edgewood, KY
  • NPI 1316136567
  NPD (past)

Affiliated clinicians 2

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

• Ahmad Anjak, MD

  • Nephrology Physician
  • Cincinnati, OH
  • NPI 1033158688

  Dialysis facility

  Care Compare affiliation Name & address match
• Amit Kumar Rajput, M.D.

  • Nephrology Physician
  • Middletown, OH
  • NPI 1457614182

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1417550476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATTN 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": "1550 GOODMAN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452241005",
            "telephone_number": "513-538-3768",
            "fax_number": "513-538-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARGHEE DIALYSIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2020-11-20",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "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": "College Hill Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adam Tardio
• Fariha Tareen, M.D.
• Zackary Tareky
• Target Health Care LLC
• Targhee Dialysis, LLC
• Rabia Tari, MD
• Taricel Management Staffing,LLC
• Richard Tarin II, RN, CNP
• Javeria Tariq, MD
• Muhammad Naveed Tariq, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.