Isd Renal Inc

Primary specialty

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

Legal business name

ISD RENAL INC

Doing business as

Lewis Creek Dialysis

Practice address

620 Mall Blvd
Ste E
Dyersburg, TN 38024-1649

Phone

(731) 287-9448

Fax

(731) 287-9623

NPI assigned

Sep 5, 2018

Last updated

Oct 15, 2026By 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 names 1

• Lewis Creek Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Isd Renal Inc

  dba Foreman Drive Home Training

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cookeville, TN
  • NPI 1003390469

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Greensboro Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Greensboro, GA
  • NPI 1073816914

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Fairmount Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1134640949

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Speedway Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Indianapolis, IN
  • NPI 1174006662

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba North Providence Renal Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • North Providence, RI
  • NPI 1174579619

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Merchantville Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pennsauken, NJ
  • NPI 1194230441

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba National Road Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bridgeport, OH
  • NPI 1205396744

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Cedar Grove Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1235795204

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba South Dean Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Englewood, NJ
  • NPI 1245891670

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Girard Estates Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Philadelphia, PA
  • NPI 1295344307

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Upper Darby Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Upper Darby, PA
  • NPI 1316540388

  6507053790

  Same PAC ID
• Isd Renal Inc

  dba Mallory Park Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dayton, OH
  • NPI 1336682707

  6507053790

  Same PAC ID

Listed as

DaVita Lewis Creek DialysisCCN 442754

Overall star rating

2.0 of 5

Ownership

Profit

Certified

May 1, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

16

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 11

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

• Isd Renal Inc

  dba Foreman Drive Home Training

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cookeville, TN
  • NPI 1003390469
  NPD tax ID
• Isd Renal Inc

  dba Wolfchase Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1184586919
  NPD tax ID
• Isd Renal Inc

  dba Poplar Avenue Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1346102001
  NPD tax ID
• Isd Renal Inc

  dba Pace Road Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1386506145
  NPD tax ID
• Isd Renal Inc

  dba Renal Care of Memphis North

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1447206172
  NPD tax ID
• Isd Renal Inc

  dba Whitehaven Renal Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1457307936
  NPD tax ID
• Isd Renal Inc

  dba Renal Care of Midtown Memphis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1649217738
  NPD tax ID
• Isd Renal Inc

  dba Chickasaw Gardens Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1659233492
  NPD tax ID
• Isd Renal Inc

  dba Quince Road Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1700748555
  NPD tax ID
• Isd Renal Inc

  dba Neely Road Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1841152600
  NPD tax ID
• Isd Renal, Inc

  dba Mt. Juliet Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Juliet, TN
  • NPI 1023461894
  NPD tax ID

Member of 1

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

• Dva Healthcare Renal Care Inc

  dba West Tampa Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tampa, FL
  • NPI 1881662120

  Member Of

  NPD member

Affiliated clinicians 3

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

• Anna Jiyoung Lee-Mulay, M.D.

  • Nephrology Physician
  • Dyersburg, TN
  • NPI 1457762304

  Dialysis facility

  Care Compare affiliation Name & address match
• Shree Ramakant Mulay, MD

  • Nephrology Physician
  • Dyersburg, TN
  • NPI 1548671845

  Dialysis facility

  Care Compare affiliation Name & address match
• Victor C Nwazue, M.D.

  • Nephrology Physician
  • Jackson, TN
  • NPI 1861657561

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1619459682",
    "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": "620 MALL BLVD",
            "address_2": "STE E",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380241649",
            "telephone_number": "731-287-9448",
            "fax_number": "731-287-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewis Creek Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janette Humpolick, PHYSICIAN ASSISTANT
• Shannon Janae Hurst, LCSW
• Charlotte Elizabeth Hutcheson, CASE MANAGER
• Independent Radiology Associates PLC
• Courtney Cape Irvin, OD
• Jackson Madison County General (Medsouth Pharmacy)
• Evelyn Nicole Jackson
• Christi L Jacobi, PHARMD
• Angeli Jain, MD
• James and Wilks Pharmacy LLC (James & Wilks Pharmacy)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.