Isd Renal Inc

Primary specialty

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

Legal business name

ISD RENAL INC

Practice address

12610 E Mirabeau Pkwy
Ste 100
Spokane Valley, WA 99216-1450

Phone

(509) 228-9933

Fax

(509) 228-9399

NPI assigned

May 25, 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 names 1

• Spokane Valley Renal Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

DaVita Spokane Valley Renal CenterCCN 502537

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Apr 26, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

13

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 4

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

• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Spokane, WA
  • NPI 1093761603
  NPD tax ID
• Isd Renal Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Spokane, WA
  • NPI 1881640720
  NPD tax ID
• Osceola Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tacoma, WA
  • NPI 1235558073
  NPD tax ID
• Renal Care of Marion

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tacoma, WA
  • NPI 1427477454
  NPD tax ID

Member of 2

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

• Dva Healthcare Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pearsall, TX
  • NPI 1194789859

  Member Of

  NPD member
• Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pageland, SC
  • NPI 1548222615

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Affiliated clinicians 1

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

• Vijayakumar K Reddy, MD

  • Nephrology Physician
  • Spokane, WA
  • NPI 1932391547

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1649226283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "LICENSURE & CERTIFICATION",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12610 E MIRABEAU PKWY",
            "address_2": "STE 100",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161450",
            "telephone_number": "509-228-9933",
            "fax_number": "509-228-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "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": "Spokane Valley Renal Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spokane Valley Renal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Inanna Iris
• Catherine Iron
• Molly Alexandrea Ironmonger, SUDP
• Rachel Kay Irwin
• Isaac Caring Home LLC
• Kristopher Alan Isherwood
• Fred Michael Itveldt, MSN
• Blessing Iwuozo
• J Blake, DMD, PS
• Taylor Jacklin, LMP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.