Active NPI
Renal Treatment Centers Mid Atlantic Inc
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Washington, DC
National Provider Identifier
1629044896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- RENAL TREATMENT CENTERS MID ATLANTIC INC
- Practice address
- 5000 Nannie Helen Burroughs Ave NE
Washington, DC 20019-5506 - Phone
- (202) 399-7700
- Fax
- (202) 399-3708
- NPI assigned
- Feb 27, 2006
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
5000 Nannie Helen Burroughs Ave NE
Washington, DC 20019-5506
Mailing address
5200 Virginia Way
L & C Department
Brentwood, TN 37027-7569
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 034379100 | Medicaid | DC | |
| 401139200 | Medicaid | MD | |
| 8080909 | Medicaid | NJ |
Other names 1
- Grant Park Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040803000612 | DC | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 4587572383 | Practice locations: Washington, DC |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita Grant Park Dialysis
- Ownership
- Profit
- Certified
- May 25, 2001
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 11
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 09D0984142 | Grant Park Dialysis | Certificate of waiver | Mar 13, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Renal Treatment Centers Mid Atlantic Inc
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.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Washington, DC
- NPI 1609842889
Locations
5000 N H Burroughs Ave NE
Washington, DC 20019
Practitioners & affiliated clinicians
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Nephrology Physician
- Upper Marlboro, MD
- NPI 1013014802
Dialysis facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773187200000",
"number": "1629044896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "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": "5000 NANNIE HELEN BURROUGHS AVE NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200195506",
"telephone_number": "202-399-7700",
"fax_number": "202-399-3708"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RENAL TREATMENT CENTERS MID ATLANTIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-27",
"last_updated": "2026-03-11",
"certification_date": "2026-03-11",
"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": "034379100",
"state": "DC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "401139200",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8080909",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Grant Park Dialysis",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Grant Park Dialysis",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.