NPIMap

Organization Active NPI

Routt Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Reno, NV
National Provider Identifier
1679713036
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
3732ESR Issued in NV
Legal business name
ROUTT DIALYSIS LLC
Practice address
685 Sierra Rose Dr
Reno, NV 89511-2060
Phone
(775) 829-6580
Fax
(775) 829-6581
NPI assigned
Feb 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 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 3732ESR NV Primary

Addresses

Primary practice location

685 Sierra Rose Dr
Reno, NV 89511-2060

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1679713036MedicaidNV

Other names 1

  • Sierra Rose Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090608000590 NV Part A Provider - End-Stage Renal Disease Facility (ESRD) 8022168301 Practice locations: Reno, NV

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Routt Dialysis LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member of 3

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

Locations

685 Sierra Rose Dr
Reno, NV 89511
Phone (775) 827-2443

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1679713036",
    "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": "685 SIERRA ROSE DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112060",
            "telephone_number": "775-829-6580",
            "fax_number": "775-829-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUTT DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "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": "NV",
            "license": "3732ESR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679713036",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Rose Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sierra Rose Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.