NPIMap

Organization Active NPI

Renal Treatment Centers-Southeast LP

Doing business as Anniston Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Anniston, AL
National Provider Identifier
1730429507
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
S0805 Issued in AL
Legal business name
RENAL TREATMENT CENTERS-SOUTHEAST LP
Doing business as
Anniston Dialysis
Practice address
1612 Noble Street
Anniston, AL 36201-3839
Phone
(256) 237-3794
Fax
(256) 238-6855
NPI assigned
Feb 15, 2013
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 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 S0805 AL Primary

Addresses

Primary practice location

1612 Noble Street
Anniston, AL 36201-3839

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
152903MedicaidAL

Other names 1

  • Anniston Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160122002338 AL Part A Provider - End-Stage Renal Disease Facility (ESRD) 1658555255 Practice locations: Anniston, AL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Anniston DialysisCCN 012666
Overall star rating
3.0 of 5
Ownership
Profit
Certified
Aug 9, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
10

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
01D2057091Anniston Dialysis1612 Noble Street, Anniston, AL 36201Certificate of waiverApr 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bradley County Dialysis137 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

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

View all 19

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1360886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1730429507",
    "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": "1612 NOBLE STREET",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362013839",
            "telephone_number": "256-237-3794",
            "fax_number": "256-238-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-SOUTHEAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-15",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "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": "AL",
            "license": "S0805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152903",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anniston Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anniston Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anniston, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.