NPIMap

Organization Active NPI

Renal Treatment Centers Mid Atlantic Inc

Doing business as Peaks of Otter Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bedford, VA
National Provider Identifier
1457907917
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RENAL TREATMENT CENTERS MID ATLANTIC INC
Doing business as
Peaks of Otter Dialysis
Practice address
570 Blue Ridge Ave
Bedford, VA 24523-2604
Phone
(540) 875-2601
Fax
(540) 875-2622
NPI assigned
Aug 12, 2019
Last updated
Apr 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 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 Primary

Addresses

Primary practice location

570 Blue Ridge Ave
Bedford, VA 24523-2604

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1457907917MedicaidVA

Other names 1

  • Peaks of Otter Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200124002419 VA Part A Provider - End-Stage Renal Disease Facility (ESRD) 4587572383 Practice locations: Bedford, VA

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
49D2177185Peaks of Otter Dialysis570 Blue Ridge Ave, Bedford, VA 24523Certificate of waiverJan 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Renal Treatment Centers Mid Atlantic Inc80 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

570 Blue Ridge Ave
Bedford, VA 24523
Phone (540) 875-2601

570 Westgate Shopping Ctr
Bedford, VA 24523
Phone (540) 875-2601

NPI Registry JSON

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1457907917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 BLUE RIDGE AVE",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245232604",
            "telephone_number": "540-875-2601",
            "fax_number": "540-875-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS MID ATLANTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "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": "1457907917",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peaks of Otter Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peaks of Otter Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bedford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.