NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as Memphis Southeast Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
National Provider Identifier
1699961680
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
174 Issued in TN
Legal business name
TOTAL RENAL CARE INC
Doing business as
Memphis Southeast Dialysis
Practice address
1805 Moriah Woods Blvd
Ste 101
Memphis, TN 38117-7121
Phone
(901) 685-3192
Fax
(901) 685-3645
NPI assigned
Sep 24, 2007
Last updated
Aug 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 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 174 TN Primary

Addresses

Primary practice location

1805 Moriah Woods Blvd
Ste 101
Memphis, TN 38117-7121

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
0442674MedicaidTN
08770897MedicaidMS
176757134MedicaidAR

Other names 1

  • Memphis Southeast Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080624000356 TN Part A Provider - End-Stage Renal Disease Facility (ESRD) 8426965229 Practice locations: Memphis, TN

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Memphis Southeast DialysisCCN 442674
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Apr 7, 2008
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
44D1076146Memphis Southeast Dialysis1805 Moriah Woods Blvd Suite #1, Memphis, TN 38117Certificate of waiverNov 5, 2027

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

1805 Moriah Woods Blvd
Ste 1
Memphis, TN 38117

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1699961680",
    "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": "1805 MORIAH WOODS BLVD",
            "address_2": "STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381177121",
            "telephone_number": "901-685-3192",
            "fax_number": "901-685-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "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": "TN",
            "license": "174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442674",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08770897",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176757134",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memphis Southeast Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memphis Southeast Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.