Southern Hills Dialysis Center LLC

Primary specialty

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

License

3999ESR1 Issued in NV

Legal business name

SOUTHERN HILLS DIALYSIS CENTER LLC

Practice address

9280 W Sunset Rd
Ste 110
Las Vegas, NV 89148-4861

Phone

(702) 318-3167

Fax

(702) 318-3196

NPI assigned

Apr 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John D Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southern Hills Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Listed as

DaVita Southern Hills Dialysis CenterCCN 292521

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jun 21, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

23

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

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

• Renal Treatment Centers California Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Napa, CA
  • NPI 1366405748

  Member Of

  NPD member
• Renal Treatment Centers West Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Oklahoma City, OK
  • NPI 1124509245

  Member Of

  NPD member

Affiliated clinicians 3

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

• Danyal Hassan, M.D.

  • Nephrology Physician
  • Las Vegas, NV
  • NPI 1548282809

  Dialysis facility

  Care Compare affiliation Name & address match
• Shahrouz Shadrou, M.D.

  • Nephrology Physician
  • Las Vegas, NV
  • NPI 1154534709

  Dialysis facility

  Care Compare affiliation Name & address match
• Nauman Tahir, MBBS

  • Nephrology Physician
  • Las Vegas, NV
  • NPI 1962633057

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1467414565",
    "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",
            "telephone_number": "615-341-6814",
            "fax_number": "800-293-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9280 W SUNSET RD",
            "address_2": "STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484861",
            "telephone_number": "702-318-3167",
            "fax_number": "702-318-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HILLS DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NV",
            "license": "3999ESR1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504696",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Hills Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Hills Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.