Renal Treatment Centers-Southeast, LP.

Primary specialty

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

License

ERD-0143 Issued in SC

Legal business name

RENAL TREATMENT CENTERS-SOUTHEAST, LP.

Doing business as

Pendleton Dialysis

Practice address

7703 Highway 76
Pendleton, SC 29670-1818

Phone

(864) 646-7715

Fax

(864) 646-7423

NPI assigned

Apr 4, 2006

Last updated

Nov 13, 2025By 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 Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pendleton Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Listed as

DaVita Pendleton DialysisCCN 422597

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Dec 16, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

10

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

Forrest City Dialysis137 organizations share this tax ID, including this one

Member of 1

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

• Bainbridge Dialysis LLC

  dba Central Fort Worth Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Worth, TX
  • NPI 1699041152

  Member Of

  NPD member

Affiliated clinicians 2

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

• Robin Edwin, MD

  • Nephrology Physician
  • Greenville, SC
  • NPI 1871756890

  Dialysis facility

  Care Compare affiliation Name & address match
• Kelly Heegard, M.D.

  • Nephrology Physician
  • Greenville, SC
  • NPI 1538397807

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1891757969",
    "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": "7703 HIGHWAY 76",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296701818",
            "telephone_number": "864-646-7715",
            "fax_number": "864-646-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-SOUTHEAST, LP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "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": "SC",
            "license": "ERD-0143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ERD143",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pendleton Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pendleton Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pendleton, SC
• Providers in Pendleton, SC by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.