Rusk Dialysis. LLC

Primary specialty

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

Legal business name

RUSK DIALYSIS. LLC

Practice address

1059 SE 82ND St
Oklahoma City, OK 73149-2999

Phone

(405) 512-6912

Fax

(405) 512-6918

NPI assigned

Dec 12, 2011

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

• Cleveland PD Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Listed as

DaVita Cleveland PDCCN 372579

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 14, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

8

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

CLIA laboratory certificates

Member of 1

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

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Castle Rock, CO
  • NPI 1386928430

  Member Of

  NPD member

Affiliated clinicians 5

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

• Anupa Khastgir, MD

  • Nephrology Physician
  • Oklahoma City, OK
  • NPI 1407813900

  Dialysis facility

  Care Compare affiliation Name & address match
• Kendral Raymon Knight, M.D.

  • Nephrology Physician
  • Norman, OK
  • NPI 1275783250

  Dialysis facility

  Care Compare affiliation Name & address match
• Cuong Dinh Nguyen, MD

  • Nephrology Physician
  • Norman, OK
  • NPI 1659497451

  Dialysis facility

  Care Compare affiliation Name & address match
• Dustin Shawn Tedesco, MD

  • Internal Medicine Physician
  • Norman, OK
  • NPI 1649476136

  Dialysis facility

  Care Compare affiliation Name & address match
• David Collier Williams, M.D.

  • Nephrology Physician
  • Norman, OK
  • NPI 1518991264

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1942578422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 SE 82ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731492999",
            "telephone_number": "405-512-6912",
            "fax_number": "405-512-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSK DIALYSIS. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "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": "200451170A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland PD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cleveland PD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Honesty M Rushing
• Katrina Russhette Rushing, MMHC, LPC (US)
• Kyleigh Rose Rushing
• Megan Rushing, PHARM.D
• Raylee Rushing
• Ethleyn Agnes Rusnak, MD
• Russell D Crain MD PC
• Russell L Hanan M D Inc
• Russell S Gornichec MD PC
• Abby Rose Russell, MD

• All providers in Oklahoma City, OK
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.