Gertrude Dialysis, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

GERTRUDE DIALYSIS, LLC

Doing business as

Dialysis Care of Grand Prairie

Practice address

402 N Carrier Pkwy
Ste 102
Grand Prairie, TX 75050-5426

Phone

(972) 264-2660

Fax

(972) 264-2687

NPI assigned

Apr 30, 2014

Last updated

Mar 12, 2025By the provider in NPPES

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Dialysis Care of Grand Prairie Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Dialysis Care of Grand PrairieCCN 672789

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Sep 13, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

13

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

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

• Bainbridge Dialysis LLC

  dba Central Fort Worth Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Worth, TX
  • NPI 1699041152

  Member Of

  NPD member
• Renal Treatment Centers-Southeast, LP.

  dba Barbour County Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Eufaula, AL
  • NPI 1326583188

  Member Of

  NPD member

Locations

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Majd I Jaradat, M.D.

  • Nephrology Physician
  • Arlington, TX
  • NPI 1245295989

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1801206883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N CARRIER PKWY",
            "address_2": "STE 102",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505426",
            "telephone_number": "972-264-2660",
            "fax_number": "972-264-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERTRUDE DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "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": "366094601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dialysis Care of Grand Prairie",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dialysis Care of Grand Prairie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cecil F George Jr., DDS
• Gerald G George, D.O.
• Jisa Saji George, PA-C
• Jane Geracci, M.S.C.C.C.
• Megan Christine Gerber
• Sonya Lavette Geter, MT
• Jasmin Ghasemloian, DO
• Lance Gholston
• Tracey Gibbs, PTA
• Gibson Pharmacy

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.