Williston Dialysis, LLC

Primary specialty

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

Legal business name

WILLISTON DIALYSIS, LLC

Doing business as

Oceana Dialysis

Practice address

1375 Oceana Blvd
Suite 114
Virginia Beach, VA 23454-5579

Phone

(757) 961-6239

Fax

(757) 961-6665

NPI assigned

Apr 26, 2016

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 and Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oceana Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Listed as

DaVita Oceana DialysisCCN 492698

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Sep 19, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

17

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.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

Affiliated clinicians 1

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

• Melbeth Morales Lusica, MD

  • Nephrology Physician
  • Virginia Beach, VA
  • NPI 1144487364

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1831544972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4214",
            "fax_number": "866-944-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 OCEANA BLVD",
            "address_2": "SUITE 114",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545579",
            "telephone_number": "757-961-6239",
            "fax_number": "757-961-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLISTON DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831544972",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oceana Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oceana Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deja Shantia Willis
• Jenny Lynn Willis, NP
• Krista Willis
• Krystal Danielle Willis
• Linda Willis
• Patricia Ann Wills, PHD
• Raneshia Wills
• Tyana Wills
• Willview Behavioral LLC.
• Janet Leigh Wilms, RPH, MBA

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.