Renal Center of Waterton, LLLP

Primary specialty

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

Legal business name

RENAL CENTER OF WATERTON, LLLP

Doing business as

Renal Center of Waterton

Practice address

2895 Shiloh Rd
Tyler, TX 75703-2936

Phone

(903) 561-0292

Fax

(903) 561-1896

NPI assigned

Sep 18, 2008

Last updated

Jun 17, 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 Wey

Title

VP Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Renal Center of Waterton Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita Renal Center of WatertonCCN 672647

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jul 14, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

20

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 1

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

• Renal Treatment Centers Northeast Inc

  dba Jennersville Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • West Grove, PA
  • NPI 1871555748

  Member Of

  NPD member

Affiliated clinicians 1

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

• Aideloje A. Onime, MD

  • Nephrology Physician
  • Tyler, TX
  • NPI 1972642965

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1811147440",
    "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": "2895 SHILOH RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032936",
            "telephone_number": "903-561-0292",
            "fax_number": "903-561-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL CENTER OF WATERTON, LLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280420501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renal Center of Waterton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Renal Care Group Texas, Inc. (Fresenius Medical Care Tyler Home Dialysis)
• Renal Care Group Texas, Inc. (West Tyler Dialysis)
• Renal Care Group Texas, Inc. (Southeast Tyler)
• Renal Care Group Texas, Inc. (Watson Wise Dialysis Center)
• Renal Center of Tyler, LP, LLLP (Renal Center Of Tyler)
• Mark B Renfro, MD
• Devyn Paige Renfroe, PTA
• Haleigh Nicole Renfroe, DDS
• Julee G Renfroe, RN
• Thomas Wilson Renfroe Jr., PSY.D

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tyler, TX
• Providers in Tyler, 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 Jun 17, 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.