NPIMap

Organization Active NPI

Renal Treatment Centers West Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Scottsbluff, NE
National Provider Identifier
1821050295
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
ESRD017 Issued in NE
Legal business name
RENAL TREATMENT CENTERS WEST INC
Doing business as
Scottsbluff Dialysis Center
Practice address
820 W 42ND St Ste 1600
Scottsbluff, NE 69361-5017
Phone
(308) 220-3572
Fax
(308) 220-3592
NPI assigned
Apr 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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 ESRD017 NE Primary

Addresses

Primary practice location

820 W 42ND St Ste 1600
Scottsbluff, NE 69361-5017

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
166123700MedicaidWY
17432383MedicaidCO

Other names 1

  • Scottsbluff Dialysis Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081113000415 NE Part A Provider - End-Stage Renal Disease Facility (ESRD) 0941118400 Practice locations: Scottsbluff, NE

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita Scottsbluff Dialysis CenterCCN 282502
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Jun 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Chain
DaVita
Dialysis stations
20

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0710880Scottsbluff Dialysis Center820 W 42ND St, Ste 1600, Scottsbluff, NE 69361Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Renal Treatment Centers West Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1821050295",
    "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": "820 W 42ND ST STE 1600",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693615017",
            "telephone_number": "308-220-3572",
            "fax_number": "308-220-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS WEST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "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": "NE",
            "license": "ESRD017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166123700",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17432383",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scottsbluff Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Scottsbluff Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsbluff, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.