Organization Active NPI

Central Iowa Dialysis Partners LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Des Moines, IA
National Provider Identifier
1922075670
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
CENTRAL IOWA DIALYSIS PARTNERS LLC
Practice address
1201 Pennsylvania Ave
Des Moines, IA 50316-2339
Phone
(515) 783-6342
Fax
(319) 253-3792
NPI assigned
Mar 1, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Samuel T Wey
Title
VP Licensure & Certification
Phone
(615) 341-6641

Member of 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 5

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
DaVita East Des Moines DialysisCCN 162533
Overall star rating
3.0 of 5
Ownership
Profit
Certified
May 11, 2005
Medicare certification status
Active (Provider of Services file)
Chain
DaVita
Dialysis stations
12

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1036002East Des Moines Dialysis1201 Pennsylvania Avenue, Des Moines, IA 50316Certificate of waiverJan 17, 2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20050727000092 IA Part a Provider - End-Stage Renal Disease Facility (ESRD) 9739117235 Practice locations: Des Moines, IA

National Provider Directory

National Provider Directory

Locations

1301 Pennsylvania Ave
#208E
Des Moines, IA 50316
Phone (515) 262-5995

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

NPPES NPI Registry

Primary practice location

1201 Pennsylvania Ave
Des Moines, IA 50316-2339

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 341-6814

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0620005MedicaidIA

Other names 1

NPPES NPI Registry
  • East Des Moines Dialysis Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 25, 2024.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1922075670",
    "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",
            "telephone_number": "615-341-6814",
            "fax_number": "800-293-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PENNSYLVANIA AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162339",
            "telephone_number": "515-783-6342",
            "fax_number": "319-253-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL IOWA DIALYSIS PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "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": "0620005",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Des Moines Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Des Moines Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.