Fairfield Dialysis LLC

Primary specialty

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

Legal business name

FAIRFIELD DIALYSIS LLC

Doing business as

Jacksonville Arlington Dialysis

Practice address

929 University Blvd N
Jacksonville, FL 32211-5529

Phone

(904) 743-1689

Fax

(904) 743-1570

NPI assigned

Dec 23, 2011

Last updated

Feb 18, 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 identifiers 1

Other names 1

• Jacksonville Arlington Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

DaVita Jacksonville Arlington DialysisCCN 682526

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Sep 11, 2012

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

Member of 1

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

• Total Renal Care, Inc.

  dba Walker South Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Walker, LA
  • NPI 1841682200

  Member Of

  NPD member

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Cuivre Dialysis LLC

  dba Cypress Fairfield Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cypress, TX
  • NPI 1326440595

  Member Of

  NPD member

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Affiliated clinicians 2

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

• Kadir Mansur, MD

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1912975236

  Dialysis facility

  Care Compare affiliation Name & address match
• Gaurav Tandon, MD

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1306069562

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1639448467",
    "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": "929 UNIVERSITY BLVD N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115529",
            "telephone_number": "904-743-1689",
            "fax_number": "904-743-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "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": "008056600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Arlington Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jacksonville Arlington Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Therese Y Fain, P.T.
• Fair and Balanced, LLC (Nirog Health Center)
• Jasmine Fair, BA
• Kayla Rose Fairchild
• Dallas Sarahann Fairdale
• Fairview Urgent Care
• Yulanda T Faison- Oyebanji, DNP, NP
• Faith Based Services, LLC
• Faith Forever Home Care LLC
• Faith Home Care Services, Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.