Organization Active NPI

Damon Dialysis LLC

Doing business as Avon Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Indianapolis, IN
National Provider Identifier
1730468836
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DAMON DIALYSIS LLC
Doing business as
Avon Dialysis
Practice address
9210 Rockville Rd
Ste D
Indianapolis, IN 46234-2670
Phone
(317) 209-2544
Fax
(317) 209-2741
NPI assigned
Aug 8, 2011
Last updated
May 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samuel 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

9210 Rockville Rd
Ste D
Indianapolis, IN 46234-2670

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
201048160AMedicaidIN

Other names 1

  • Avon Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110908002286 IN Part A Provider - End-Stage Renal Disease Facility (ESRD) 5496925042 Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Member of 2

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

Locations

9210 Rockville Rd
Ste D
Indianapolis, IN 46234
Phone (317) 209-2544

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777593600000",
    "number": "1730468836",
    "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": "9210 ROCKVILLE RD",
            "address_2": "STE D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462342670",
            "telephone_number": "317-209-2544",
            "fax_number": "317-209-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMON DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-08",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": "201048160A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avon Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avon Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.