Joshua Dialysis LLC

Primary specialty

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

Legal business name

JOSHUA DIALYSIS LLC

Doing business as

Andover Dialysis

Practice address

626 S Andover Rd Ste 900
Andover, KS 67002-8910

Phone

(316) 733-2984

Fax

(316) 733-4138

NPI assigned

Nov 20, 2012

Last updated

Dec 21, 2023By 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 names 1

• Andover Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Listed as

DaVita Andover DialysisCCN 172557

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Jun 4, 2013

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 Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  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, and the practitioner matching its NPPES authorized official.

• Ushasri Challa, M.D.

  • Nephrology Physician
  • Wichita, KS
  • NPI 1992756563
  NPD (past)

Affiliated clinicians 4

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

• Jany Khairallah Moussa, M.D.

  • Nephrology Physician
  • Wichita, KS
  • NPI 1861443459

  Dialysis facility

  Care Compare affiliation Name & address match
• Ronnie K Moussa, MD

  • Internal Medicine Physician
  • Wichita, KS
  • NPI 1437316387

  Dialysis facility

  Care Compare affiliation Name & address match
• Mohamad S Sandid, M.D.

  • Nephrology Physician
  • Wichita, KS
  • NPI 1992778518

  Dialysis facility

  Care Compare affiliation Name & address match
• Levi Curtis Short, MD

  • Nephrology Physician
  • Wichita, KS
  • NPI 1790198448

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1679817258",
    "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",
            "telephone_number": "615-320-4268",
            "fax_number": "877-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 S ANDOVER RD STE 900",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670028910",
            "telephone_number": "316-733-2984",
            "fax_number": "316-733-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andover Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Andover Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Andover, KS
• Providers in Andover, KS by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.