NPIMap

Organization Active NPI

Dva Washington University Healthcare of Greater St Louis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hazelwood, MO
National Provider Identifier
1831032804
Registry record updated Sep 10, 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 WASHINGTON UNIVERSITY HEALTHCARE OF GREATER ST LOUIS LLC
Practice address
1 Village Square Shopping Center
Suite 1
Hazelwood, MO 63042-1817
Phone
(314) 442-0138
NPI assigned
Apr 13, 2026
Organization subpart
Yes
Parent organization
DAVITA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sam T Wey
Title
VP, Licensure and 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

1 Village Square Shopping Center
Suite 1
Hazelwood, MO 63042-1817

Mailing address

5200 Virginia Way
Licensure and Certification Dept
Brentwood, TN 37027-7569

Other names 1

  • Village Square Dialysis Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dva Washington University Healthcare of Greater St Louis LLC5 organizations share this tax ID, including this one
Part of
Davita Inc

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1776038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1831032804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "LICENSURE AND CERTIFICATION DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VILLAGE SQUARE SHOPPING CENTER",
            "address_2": "SUITE 1",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421817",
            "telephone_number": "314-442-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA WASHINGTON UNIVERSITY HEALTHCARE OF GREATER ST LOUIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2026-04-13",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP, LICENSURE AND 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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Square Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazelwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.