NPIMap

Organization Active NPI

Southwest Kidney Davita Dialysis Partners, LLC

Doing business as Dialysis Care at Palm Valley

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goodyear, AZ
National Provider Identifier
1437612165
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS, LLC
Doing business as
Dialysis Care at Palm Valley
Practice address
14620 W Encanto Blvd
Ste 110
Goodyear, AZ 85395-1616
Phone
(623) 526-3332
Fax
(623) 321-2057
NPI assigned
Apr 10, 2019
Last updated
May 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 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

14620 W Encanto Blvd
Ste 110
Goodyear, AZ 85395-1616

Mailing address

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

Other names 1

  • Dialysis Care at Palm Valley Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190912003257 AZ Part A Provider - End-Stage Renal Disease Facility (ESRD) 1456438423 Practice locations: Goodyear, AZ

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Dialysis Care at Palm ValleyCCN 032658
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Nov 6, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
24

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
03D2165551Dialysis Care at Palm Valley14620 W Encanto Blvd Ste 110, Goodyear, AZ 85395Certificate of waiverApr 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Southwest Kidney Davita Dialysis Partners LLC22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Member of 1

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

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": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1437612165",
    "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": "14620 W ENCANTO BLVD",
            "address_2": "STE 110",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951616",
            "telephone_number": "623-526-3332",
            "fax_number": "623-321-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2025-05-07",
        "certification_date": "2025-04-28",
        "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": "Dialysis Care at Palm Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dialysis Care at Palm Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.