Vilander Dialysis LLC

Primary specialty

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

Legal business name

VILANDER DIALYSIS LLC

Doing business as

Lilburn Dialysis

Practice address

4805 Lawrenceville Hwy NW Ste 320B
Lilburn, GA 30047-3859

Phone

(770) 381-7544

Fax

(770) 381-9857

NPI assigned

Aug 23, 2017

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

• Lilburn Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

DaVita Lilburn DialysisCCN 852545

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jul 3, 2018

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 2

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

• Renal Treatment Centers Mid Atlantic Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Goldsboro, NC
  • NPI 1174086698

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelsey Reigh Killian-Purser, RN

  • Registered Nurse
  • Lilburn, GA
  • NPI 1700737574
  NPD (past)

Affiliated clinicians 2

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

• Mazen A Abdalla, M.D.

  • Nephrology Physician
  • Snellville, GA
  • NPI 1467420893

  Dialysis facility

  Care Compare affiliation Name & address match
• Divakar Jammalamadaka, MD

  • Nephrology Physician
  • Snellville, GA
  • NPI 1265699920

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1659898492",
    "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": "4805 LAWRENCEVILLE HWY NW STE 320B",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473859",
            "telephone_number": "770-381-7544",
            "fax_number": "770-381-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILANDER DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-23",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "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": "003208626A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lilburn Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lilburn Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• George Varghese, RPH
• Subin Varughese, PHARM.D.
• Lemaire Ventura, DC
• Nicholas Vernola Jr., PT, DPT, SDN
• Parker Vidmar
• Village Family Dental LLC
• Destiny Vincent, RBT
• Vitalfort LLC
• Vitalpath Care LLC
• Gia Uyen Van Vo

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Lilburn, GA
• Providers in Lilburn, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.