NPIMap

Organization Active NPI

Bainbridge Dialysis LLC

Doing business as Central Fort Worth Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1699041152
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
BAINBRIDGE DIALYSIS LLC
Doing business as
Central Fort Worth Dialysis
Practice address
1000 Saint Louis Ave Ste 101
Fort Worth, TX 76104-3377
Phone
(817) 810-0379
Fax
(817) 870-9767
NPI assigned
Mar 29, 2012
Last updated
Feb 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

1000 Saint Louis Ave Ste 101
Fort Worth, TX 76104-3377

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
3397549-01MedicaidTX

Other names 1

  • Central Fort Worth Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120215000787 TX Part A Provider - End-Stage Renal Disease Facility (ESRD) 7315855715 Practice locations: Fort Worth, TX

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Central Fort Worth DialysisCCN 672723
Overall star rating
2.0 of 5
Ownership
Profit
Certified
May 9, 2014
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.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2038071Bainbridge Dialysis, LLC1000 Saint Louis Ave Suite 101, Fort Worth, TX 76104Certificate of waiverMar 11, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Member organizations 66

Organizations listed as members of this organization in the National Provider Directory.

View all 66

Locations

1000 Saint Louis Ave
Ste 101
Fort Worth, TX 76104
Phone (817) 810-0379

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771545600000",
    "number": "1699041152",
    "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": "1000 SAINT LOUIS AVE STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043377",
            "telephone_number": "817-810-0379",
            "fax_number": "817-870-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAINBRIDGE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "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": "3397549-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Fort Worth Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Fort Worth Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.