NPIMap

Organization Active NPI

Dva Healthcare Southwest Ohio LLC

Doing business as Winton Road Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cincinnati, OH
National Provider Identifier
1699739789
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
0523DC Issued in OH
Legal business name
DVA HEALTHCARE SOUTHWEST OHIO LLC
Doing business as
Winton Road Dialysis
Practice address
6550 Winton Rd
Cincinnati, OH 45224-1327
Phone
(513) 591-2900
Fax
(513) 591-0208
NPI assigned
Apr 14, 2006
Last updated
Dec 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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 0523DC OH Primary

Addresses

Primary practice location

6550 Winton Rd
Cincinnati, OH 45224-1327

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 238-3051

Other identifiers 2

IdentifierTypeStateIssuer
3900017900MedicaidKY
2120994MedicaidOH

Other names 1

  • Winton Road Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030501000020 OH Part A Provider - End-Stage Renal Disease Facility (ESRD) 8820908668 Practice locations: Cincinnati, OH

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Winton Road DialysisCCN 362611
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Mar 10, 1999
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
36D0949611Winton Road Dialysis6550 Winton Road, Cincinnati, OH 45224Certificate of waiverAug 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Dva Healthcare Southwest Ohio LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Member of 2

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

Locations

6550 Winton Rd
Cincinnati, OH 45224
Phone (513) 591-2900

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1699739789",
    "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": "615-238-3051",
            "fax_number": "800-246-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 WINTON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452241327",
            "telephone_number": "513-591-2900",
            "fax_number": "513-591-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE SOUTHWEST OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "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": "OH",
            "license": "0523DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3900017900",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2120994",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winton Road Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Winton Road Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.