Central Carolina Dialysis Centers LLC

Primary specialty

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

Legal business name

CENTRAL CAROLINA DIALYSIS CENTERS LLC

Practice address

1607 N Main St
Kannapolis, NC 28081-2317

Phone

(704) 933-0809

Fax

(704) 932-6964

NPI assigned

Mar 22, 2006

Organization subpart

No

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 identifiers 1

Other names 1

• Dialysis Care of Kannapolis Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

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).

• Central Carolina Dialysis Centers LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Concord, NC
  • NPI 1417916909

  2567447394

  Same PAC ID

Listed as

DaVita Dialysis Care of KannapolisCCN 342592

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Dec 19, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

27

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

Central Carolina Dialysis Centers LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Central Carolina Dialysis Centers LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Concord, NC
  • NPI 1417916909
  NPD tax ID

Member of 2

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

• Total Renal Care of North Carolina, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Arden, NC
  • NPI 1497398416

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Affiliated clinicians 2

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

• Mehul Balubhai Patel, M.D.

  • Nephrology Physician
  • Concord, NC
  • NPI 1750549721

  Dialysis facility

  Care Compare affiliation Name & address match
• Mona Walid Shaban, MD

  • Nephrology Physician
  • Concord, NC
  • NPI 1053758714

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1447219969",
    "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": "1607 N MAIN ST",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280812317",
            "telephone_number": "704-933-0809",
            "fax_number": "704-932-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CAROLINA DIALYSIS CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3412592",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dialysis Care of Kannapolis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dialysis Care of Kannapolis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Carter
• Shantela M. Carter
• Shema Philistines Carter
• Dennis Clay Caudill, D.C.
• Centerwell Certified Healthcare Corp.
• Chapman Pharmacy
• Nathallie Lynnette Chavez, LCSWA
• Thomas R. Chicora, LCAS, LPC
• Tonda Ellington Childers, MA; LPCA
• Donna Childress, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kannapolis, NC
• Providers in Kannapolis, NC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in North Carolina

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