Sugarite Dialysis LLC

Primary specialty

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

Legal business name

SUGARITE DIALYSIS LLC

Practice address

4600 Shelbyville Rd
Ste 310
Louisville, KY 40207-2391

Phone

(502) 893-4791

Fax

(502) 893-4793

NPI assigned

May 25, 2011

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

• Shelbyville Road Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Listed as

DaVita Shelbyville Road DialysisCCN 182614

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Oct 12, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

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 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Napa, CA
  • NPI 1295024206

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tariq Mehmood, MD

  • Infectious Disease Physician
  • Louisville, KY
  • NPI 1134239619
  NPD (past)

Affiliated clinicians 2

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

• Andrew James Dailey, M.D.

  • Nephrology Physician
  • Louisville, KY
  • NPI 1083709893

  Dialysis facility

  Care Compare affiliation Name & address match
• Kavitha Tallapaneni, MD

  • Nephrology Physician
  • Louisville, KY
  • NPI 1184620031

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1497048342",
    "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",
            "telephone_number": "615-238-3051",
            "fax_number": "800-246-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 SHELBYVILLE RD",
            "address_2": "STE 310",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402072391",
            "telephone_number": "502-893-4791",
            "fax_number": "502-893-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGARITE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-01",
        "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": "7100201730",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelbyville Road Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shelbyville Road Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robin Lynn Sublett, PH.D.
• Sublime Healing LLC
• Meghana Suchak, PHD
• Marina Sud
• Amanda Nicole Suell
• Kathleen Sugg, SLP.D, CCC-SLP
• Lynda A Sugg, ARNP MSN
• Cocanut Mohammed Suhail, PHARMD
• Alexander Sukhorukov, D.M.D.
• Touqeer A Sulehria, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.