Organization Active NPI

Green Desert Dialysis LLC

Doing business as Desert Springs Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1427090828
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
4681ESR-1 Issued in NV
Legal business name
GREEN DESERT DIALYSIS LLC
Doing business as
Desert Springs Dialysis
Practice address
2110 E Flamingo Rd Ste 108
Las Vegas, NV 89119-5191
Phone
(702) 696-9768
Fax
(702) 791-6926
NPI assigned
Jun 11, 2006
Last updated
Mar 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 4681ESR-1 NV Primary

Addresses

Primary practice location

2110 E Flamingo Rd Ste 108
Las Vegas, NV 89119-5191

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1427090828MedicaidNV

Other names 1

  • Desert Springs Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070809000739 NV Part A Provider - End-Stage Renal Disease Facility (ESRD) 2567553274 Practice locations: Las Vegas, NV

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Desert Springs DialysisCCN 292525
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Apr 25, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
18

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory

Member of 1

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

Locations

2110 E Flamingo Rd
Ste 108
Las Vegas, NV 89119
Phone (702) 696-9768

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 1

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": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1427090828",
    "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": "2110 E FLAMINGO RD STE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195191",
            "telephone_number": "702-696-9768",
            "fax_number": "702-791-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN DESERT DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "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": "NV",
            "license": "4681ESR-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427090828",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Springs Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Desert Springs Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.