Dva Healthcare Renal Care Inc

Primary specialty

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

Legal business name

DVA HEALTHCARE RENAL CARE INC

Practice address

11014 Haskell Ave
Kansas City, KS 66109-4404

Phone

(913) 721-9780

Fax

(913) 721-9818

NPI assigned

Mar 20, 2006

Organization subpart

No

Name

Samuel Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

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

• Dva Healthcare Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lenexa, KS
  • NPI 1679532402
  NPD tax ID

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

• Dva Renal Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pageland, SC
  • NPI 1548222615
  NPD member Member Of

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

• Venu Nair, MD

  • Nephrology Physician
  • Kansas City, KS
  • NPI 1184783193
  Care Compare affiliation Name & address match Dialysis facility
• Archana Goel, MD

  • Nephrology Physician
  • Kansas City, MO
  • NPI 1679684690
  Care Compare affiliation Name & address match Dialysis facility

Listed as

DaVita Wyandotte West DialysisCCN 172536

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Mar 11, 1999

Medicare certification status

Active (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

Medicare fee-for-service enrollment

Enrolled in KS

Tax ID family

CDS of Zephyrhills (194 organizations share this tax ID)

• Wyandotte West Dialysis Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 23, 2024.

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1902865876",
    "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": "11014 HASKELL AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661094404",
            "telephone_number": "913-721-9780",
            "fax_number": "913-721-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA HEALTHCARE RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100213850N",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "946155373A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505217406",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyandotte West Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wyandotte West Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby Lynn Durler, MD
• Reginald W Dusing, M.D.
• Kortnie Duthoo, FNP-C
• Sowjanya Duthuluru, M.D.
• Dva Healthcare Renal Care Inc
• Meagan Leigh Dwyer, PH.D.
• Timothy T Dwyer III, M.D.
• Kristin Lynn Dyer, CRNA
• Eagle Case Management LLC
• George Ann Eaks, ARNP

• All providers in Kansas City, KS
• 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 May 23, 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.