NPIMap

Organization Active NPI

Renal Treatment Centers Mid Atlantic Inc

Doing business as Reston Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Herndon, VA
National Provider Identifier
1750345732
Registry record updated Jan 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
RENAL TREATMENT CENTERS MID ATLANTIC INC
Doing business as
Reston Dialysis Center
Practice address
530 Huntmar Park Dr
Ste D
Herndon, VA 20170-5100
Phone
(703) 437-0414
Fax
(703) 437-0498
NPI assigned
Apr 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 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

530 Huntmar Park Dr
Ste D
Herndon, VA 20170-5100

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1750345732MedicaidVA

Other names 1

  • Reston Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000487 VA Part A Provider - End-Stage Renal Disease Facility (ESRD) 4587572383 Practice locations: Herndon, VA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Reston Dialysis CenterCCN 492625
Overall star rating
4.0 of 5
Ownership
Profit
Certified
Feb 23, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
17

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
49D1020907Reston Dialysis Center530 Huntmar Park Drive - Suite D, Herndon, VA 20170Certificate of waiverJan 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Renal Treatment Centers Mid Atlantic Inc80 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

530 Huntmar Park Dr
Herndon, VA 20170

530 Huntmar Park Dr
#D
Herndon, VA 20170
Phone (703) 437-0414

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1768867200000",
    "number": "1750345732",
    "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": "530 HUNTMAR PARK DR",
            "address_2": "STE D",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705100",
            "telephone_number": "703-437-0414",
            "fax_number": "703-437-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS MID ATLANTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "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": "1750345732",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reston Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Reston Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Herndon, VA

Sources for this page

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