NPIMap

Organization Active NPI

Dva Renal Healthcare Inc

Doing business as Sierra Vista Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sierra Vista, AZ
National Provider Identifier
1942274493
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
OTC605 Issued in AZ
Legal business name
DVA RENAL HEALTHCARE INC
Doing business as
Sierra Vista Dialysis
Practice address
629 N Hwy 90 Byp Ste 6
Sierra Vista, AZ 85635-2257
Phone
(520) 459-7791
Fax
(520) 459-7129
NPI assigned
Feb 13, 2006
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X OTC605 AZ Primary

Addresses

Primary practice location

629 N Hwy 90 Byp Ste 6
Sierra Vista, AZ 85635-2257

Mailing address

5200 Virginia Way
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
106535MedicaidAZ

Other names 1

  • Sierra Vista Dialysis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030225000003 AZ Part A Provider - End-Stage Renal Disease Facility (ESRD) 0840107611 Practice locations: Sierra Vista, AZ

National Provider Directory

National Provider Directory
Tax ID family
Dva Renal Healthcare Inc173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

629 N Highway 90 Byp
Ste 6
Sierra Vista, AZ 85635
Phone (520) 459-7791

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1942274493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N HWY 90 BYP STE 6",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352257",
            "telephone_number": "520-459-7791",
            "fax_number": "520-459-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVA RENAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "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": "AZ",
            "license": "OTC605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106535",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Vista Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sierra Vista Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.