Isd Renal Inc

Primary specialty

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

License

OTC 3995 Issued in AZ

Legal business name

ISD RENAL INC

Doing business as

Cottonwood Dialysis

Practice address

1699 E Cottonwood St
Ste A200
Cottonwood, AZ 86326-4604

Phone

(928) 634-9295

Fax

(928) 634-9683

NPI assigned

May 24, 2006

Last updated

Sep 12, 2025By the provider in NPPES

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

• Cottonwood Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

DaVita Cottonwood DialysisCCN 032562

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Dec 1, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

10

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

Renal Care of Marion88 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

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

• Isd Renal Inc

  dba Prescott Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Prescott, AZ
  • NPI 1205881232
  NPD tax ID

Member of 2

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

• Dva Healthcare Renal Care Inc

  dba Central Bamberg Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bamberg, SC
  • NPI 1639131741

  Member Of

  NPD member
• Dva Renal Healthcare Inc

  dba Durham West Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Durham, NC
  • NPI 1275592602

  Member Of

  NPD member

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Affiliated clinicians 3

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

• Solomiia Savedchuk, MD

  • Nephrology Physician
  • Prescott Valley, AZ
  • NPI 1932629136

  Dialysis facility

  Care Compare affiliation Name & address match
• Wei Xiang Wong

  • Nephrology Physician
  • Flagstaff, AZ
  • NPI 1639551526

  Dialysis facility

  Care Compare affiliation Name & address match
• Rajiv Sinanan, MBBS

  • Nephrology Physician
  • Cookeville, TN
  • NPI 1457737728

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1568417681",
    "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": "1699 E COTTONWOOD ST",
            "address_2": "STE A200",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264604",
            "telephone_number": "928-634-9295",
            "fax_number": "928-634-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "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": "AZ",
            "license": "OTC 3995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151391",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cottonwood Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cottonwood Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Ing-Dobrota, RD
• Worakarn Victor Ingkanisorn, MD
• Inxon, Inc (Verde Valley Physical Therapy Center)
• Shirley Jane Isaacson, M.S.
• Isabelle Shook LPC PLLC
• Guy Jaaskelainen
• Zach Jablow, LMT
• Edward C Jackman, M.D.
• Peggy A James, LCSW
• Dipak Jana, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.