NPIMap

Organization Active NPI

Dva Renal Healthcare Inc

Doing business as Cedarburg Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cedarburg, WI
National Provider Identifier
1811951627
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DVA RENAL HEALTHCARE INC
Doing business as
Cedarburg Dialysis
Practice address
N54 W 6135 Mill St
Ste 400
Cedarburg, WI 53012-2021
Phone
(262) 376-8011
Fax
(262) 376-9369
NPI assigned
Apr 17, 2006
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

N54 W 6135 Mill St
Ste 400
Cedarburg, WI 53012-2021

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
1811951627MedicaidWI

Other names 1

  • Cedarburg Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030305000033 WI Part A Provider - End-Stage Renal Disease Facility (ESRD) 0840107611 Practice locations: Cedarburg, WI

National Provider Directory

National Provider Directory
Tax ID family
Gambro Healthcare Escon173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 5

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

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1811951627",
    "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": "N54 W 6135 MILL ST",
            "address_2": "STE 400",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122021",
            "telephone_number": "262-376-8011",
            "fax_number": "262-376-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "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": "1811951627",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedarburg Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cedarburg Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.