Renal Center of Mountain Home LLC

Primary specialty

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

Legal business name

RENAL CENTER OF MOUNTAIN HOME LLC

Doing business as

Renal Center of Mountain Home

Practice address

200 E 8TH St Ste 101
Mountain Home, AR 72653-4402

Phone

(870) 508-6500

Fax

(870) 508-6550

NPI assigned

Jun 2, 2006

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

• Renal Center of Mountain Home Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Listed as

DaVita Renal Center of Mountain HomeCCN 042567

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Apr 1, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

20

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.

• Renal Treatment Centers Northeast Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lehighton, PA
  • NPI 1598727372

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Grant Mathews, MD

  • Nephrology Physician
  • Mountain Home, AR
  • NPI 1689898843

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1629015979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 8TH ST STE 101",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726534402",
            "telephone_number": "870-508-6500",
            "fax_number": "870-508-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL CENTER OF MOUNTAIN HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "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": "146280734",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renal Center of Mountain Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jodylyn Reeves
• Maghen Reeves
• Regional Family Medicine PA
• Regional Orthopaedic Health Care
• Relief Center, LLC
• Miranda Lauren Reynolds
• Joyce Marie Rhoads, AT
• Vicky Richardson, MHPP
• Diana Sue Riley, P.A.
• Donna Riley

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.