Isd Renal Inc

Primary specialty

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

Legal business name

ISD RENAL INC

Doing business as

Harrisonville Renal Center

Practice address

308 Galaxie Ave
Harrisonville, MO 64701-2084

Phone

(816) 380-2004

Fax

(816) 380-7692

NPI assigned

May 25, 2006

Last updated

Sep 21, 2026By 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

• Harrisonville Renal Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Isd Renal Inc

  dba Marshall Renal Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Marshall, MO
  • NPI 1043266513

  O20060508000318

  Same enrollment

Listed as

DaVita Harrisonville Renal CenterCCN 262523

Overall star rating

2.0 of 5

Ownership

Profit

Certified

May 19, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

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

CLIA laboratory certificates

Tax ID family

Renal Care of Marion88 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

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

• Isd Renal Inc

  dba Rolla Home Training

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rolla, MO
  • NPI 1063923753
  NPD tax ID
• Isd Renal Inc

  dba Cross Keys Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Florissant, MO
  • NPI 1407384274
  NPD tax ID
• Isd Renal Inc

  dba Kansas City Renal Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Kansas City, MO
  • NPI 1770539108
  NPD tax ID
• Isd Renal, Inc.

  dba Cross Keys Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Florissant, MO
  • NPI 1376077123
  NPD tax ID

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Affiliated clinicians 1

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

• Ryan Matthew Lustig I, M.D.

  • Nephrology Physician
  • Kansas City, MO
  • NPI 1124246335

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1811943756",
    "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": "308 GALAXIE AVE",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647012084",
            "telephone_number": "816-380-2004",
            "fax_number": "816-380-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD RENAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811943756",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harrisonville Renal Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harrisonville Renal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Lynn Houchen, PHARM. D.
• Jack Ryan Hudkins, MD
• Iniquitoria LLC
• Innerbridge Wellness Group LLC
• Kimberly Dawn Ireland, MS CCC SLP
• Pamela Ann Jackson, CRADC
• Janet Lynne James, LCSW
• Aimee Johnson, LCSW, LSCSW
• Samantha Leona Johnston, COTA
• Patricia Lee Jones- Paul, LCSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Harrisonville, MO
• Providers in Harrisonville, MO by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.