Robertsville Dialysis LLC

Primary specialty

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

Legal business name

ROBERTSVILLE DIALYSIS LLC

Doing business as

Air Capital Dialysis

Practice address

1812 S Seneca St
Ste 110
Wichita, KS 67213-4100

Phone

(316) 263-1248

Fax

(316) 263-1521

NPI assigned

Aug 6, 2016

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

• Air Capital Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba New Martinsville Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Martinsville, WV
  • NPI 1396272332

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ronnie K Moussa, MD

  • Internal Medicine Physician
  • Wichita, KS
  • NPI 1437316387
  NPD (past)

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

{
    "created_epoch": "1470441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1881148948",
    "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": "1812 S SENECA ST",
            "address_2": "STE 110",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672134100",
            "telephone_number": "316-263-1248",
            "fax_number": "316-263-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTSVILLE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-06",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "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": "30004627640001",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Air Capital Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Air Capital Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeanette Michelle Robertson, PH.D., LCMFT
• Kendall Robertson
• Matthew Eric Robertson, DMD
• Megan Rene Robertson, CRNA
• Monica L Robertson, OTR
• Terry Lee Robey, LCMFT, LCAC
• John C Robichaux, MD
• Nathan Robillard, MD
• Connor Michael Robinette
• Amani Robinson-Kimani, LPC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.