NPIMap

Organization Active NPI

Renal Treatment Centers-Illinois Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Norfolk, NE
National Provider Identifier
1659640522
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
RENAL TREATMENT CENTERS-ILLINOIS INC.
Practice address
610 S 13TH St
Norfolk, NE 68701-4969
Phone
(402) 371-9559
Fax
(402) 371-7167
NPI assigned
Dec 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

610 S 13TH St
Norfolk, NE 68701-4969

Mailing address

5200 Virginia Way
Att: L&C Dept
Brentwood, TN 37027-7569

Other practice location 1

1603 W Prospect Ave
Norfolk, NE 68701-3683
Phone (402) 379-2913

Other identifiers 1

IdentifierTypeStateIssuer
100262715-00MedicaidNE

Other names 1

  • N.E. Nebraska Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120120000199 NE Part A Provider - End-Stage Renal Disease Facility (ESRD) 2365359965 Practice locations: Norfolk, NE

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita N.E. Nebraska DialysisCCN 282530
Overall star rating
5.0 of 5
Ownership
Profit
Certified
Dec 1, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
24

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Renal Treatment Centers - Illinois Inc85 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

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

Locations

1603 W Prospect Ave
Norfolk, NE 68701
Phone (402) 379-2913

Practitioners & affiliated clinicians

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1659640522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: 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": "610 S 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014969",
            "telephone_number": "402-371-9559",
            "fax_number": "402-371-7167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1603 W Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "NE",
            "postal_code": "687013683",
            "country_code": "US",
            "telephone_number": "402-379-2913",
            "fax_number": "402-379-2952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-ILLINOIS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "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": "100262715-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N.E. Nebraska Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.