NPIMap

Organization Active NPI

Renal Treatment Centers-Illinois Inc

Doing business as Omaha Harrison Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Omaha, NE
National Provider Identifier
1760766984
Registry record updated Jun 10, 2024
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-ILLINOIS INC
Doing business as
Omaha Harrison Dialysis
Practice address
6610 S 168TH St
Ste 8
Omaha, NE 68135-5412
Phone
(402) 896-4609
Fax
(402) 896-1439
NPI assigned
Oct 6, 2011
Last updated
Jun 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 Primary

Addresses

Primary practice location

6610 S 168TH St
Ste 8
Omaha, NE 68135-5412

Mailing address

5200 Virginia Way
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
10026218400MedicaidNE

Other names 1

  • Omaha Harrison Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111114000645 NE Part A Provider - End-Stage Renal Disease Facility (ESRD) 2365359965 Practice locations: Omaha, NE

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Omaha Harrison DialysisCCN 282529
Overall star rating
3.0 of 5
Ownership
Profit
Certified
May 29, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
12

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
28D2034454Omaha Harrison Dialysis6610 South 168TH Street, Suite 8, Omaha, NE 68135Certificate of waiverDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Renal Treatment Centers-Illinois Inc85 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

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

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": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1760766984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6610 S 168TH ST",
            "address_2": "STE 8",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681355412",
            "telephone_number": "402-896-4609",
            "fax_number": "402-896-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-ILLINOIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-06",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "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": "10026218400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omaha Harrison Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omaha Harrison Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.