Red Willow Dialysis LLC

Primary specialty

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

Legal business name

RED WILLOW DIALYSIS LLC

Doing business as

Cottman Kidney Center

Practice address

7198 Castor Ave
Philadelphia, PA 19149-1105

Phone

(215) 745-4060

Fax

(215) 745-0139

NPI assigned

Apr 28, 2010

Last updated

Jan 15, 2026By the provider in NPPES

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

• Cottman Kidney Center Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Red Willow Dialysis LLC

  dba Willow Grove Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Willow Grove, PA
  • NPI 1033427646

  9234279902

  Same PAC ID
• Red Willow Dialysis LLC

  dba Franklin Commons Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Warminster, PA
  • NPI 1164758033

  9234279902

  Same PAC ID

Listed as

DaVita Cottman Kidney CenterCCN 392766

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Sep 27, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

24

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

CLIA laboratory certificates

Tax ID family

Cottman Kidney Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Red Willow Dialysis LLC

  dba Willow Grove Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Willow Grove, PA
  • NPI 1033427646
  NPD tax ID
• Red Willow Dialysis LLC

  dba Franklin Commons Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Warminster, PA
  • NPI 1164758033
  NPD tax ID

Member of 1

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

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

Affiliated clinicians 2

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

• Anna Dubyanskite, MD

  • Nephrology Physician
  • Philadelphia, PA
  • NPI 1134230923

  Dialysis facility

  Care Compare affiliation Name & address match
• Majid Afzal Khan, M.D.

  • Nephrology Physician
  • Willow Grove, PA
  • NPI 1083983886

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1881911998",
    "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": "7198 CASTOR AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491105",
            "telephone_number": "215-745-4060",
            "fax_number": "215-745-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED WILLOW DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-28",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "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": "1024543460002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cottman Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cottman Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alonzo W Redden
• Renee Vernell Redden, NP
• Scott G Redden, NURSE PRACTITIONER
• Molly Redding

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.