Dva Healthcare Renal Care Inc
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Saint Peters, MO
NPI 1790746246 · NPPES record last updated Apr 8, 2026
Key facts
- NPI
- 1790746246
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- DVA HEALTHCARE RENAL CARE INC
- Practice address
- 300 First Executive Ave
Ste a
Saint Peters, MO 63376-1655 - Phone
- (636) 441-6070
- Fax
- (636) 441-6367
- NPI assigned
- Mar 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Samuel Wey
- Title
- VP Licensure & Certification
- Phone
- (615) 341-6641
Corporate family (same tax ID) 3
Member of 1
Affiliated clinicians 3
-
Piotr T Dyk, M.D.
-
Gary G Singer, M.D.
Medicare Care Compare: Dialysis facility
- Listed as
- DaVita St. Peters Dialysis
- Overall star rating
- ★★★☆☆ 3.0 of 5
- Ownership
- Profit
- Certified
- Feb 12, 2003
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 12
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1006320 | St Peters Dialysis | Certificate of waiver | Nov 13, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030110000007 | MO | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 7517875545 | Practice locations: St Peters, MO |
National Provider Directory
- Tax ID family
- CDS of Zephyrhills
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
300 First Executive Ave
Ste a
Saint Peters, MO 63376-1655
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 506060201 | Medicaid | MO | |
| 952977915010 | Medicaid | IL |
Other names
- St Peters Dialysis
Other providers in Saint Peters, MO
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- Jessica Dusablon
- Aaron Andrew Dwan
- Mark C Dyhouse
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All providers in Saint Peters, MO · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.