Stines Dialysis LLC

Primary specialty

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

Legal business name

STINES DIALYSIS LLC

Practice address

230 Clearfield Ave
Ste 106
Virginia Beach, VA 23462-1832

Phone

(757) 518-9439

Fax

(757) 519-9519

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tidewater Home Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Listed as

DaVita Tidewater Home DialysisCCN 492669

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Jun 24, 2013

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
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Affiliated clinicians 7

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

• Haidr Agha, M.D.

  • Nephrology Physician
  • Virginia Beach, VA
  • NPI 1003048117

  Dialysis facility

  Care Compare affiliation Name & address match
• Malik Asad Anjum, M.D.

  • Nephrology Physician
  • Norfolk, VA
  • NPI 1386902104

  Dialysis facility

  Care Compare affiliation Name & address match
• Kiranjit Kaur Dhillon, MD

  • Nephrology Physician
  • Norfolk, VA
  • NPI 1598722803

  Dialysis facility

  Care Compare affiliation Name & address match
• Madhu K Kolli, MD

  • Nephrology Physician
  • Virginia Beach, VA
  • NPI 1114900552

  Dialysis facility

  Care Compare affiliation Name & address match
• Melbeth Morales Lusica, MD

  • Nephrology Physician
  • Virginia Beach, VA
  • NPI 1144487364

  Dialysis facility

  Care Compare affiliation Name & address match
• Anitha Murthy, MD

  • Specialist
  • Virginia Beach, VA
  • NPI 1346204021

  Dialysis facility

  Care Compare affiliation Name & address match
• Daniel A Rakowski, MD

  • Nephrology Physician
  • Chesapeake, VA
  • NPI 1275504029

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1609110758",
    "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": "230 CLEARFIELD AVE",
            "address_2": "STE 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621832",
            "telephone_number": "757-518-9439",
            "fax_number": "757-519-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STINES DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609110758",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tidewater Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tidewater Home Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Virginia Beach, VA
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.