Ripley Dialysis LLC

Primary specialty

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

Legal business name

RIPLEY DIALYSIS LLC

Practice address

854 Highway 51 S
Ripley, TN 38063-5536

Phone

(731) 221-1883

Fax

(731) 221-8022

NPI assigned

Mar 18, 2009

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

• Ripley Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

DaVita Ripley Dialysis CenterCCN 442696

Overall star rating

3.0 of 5

Ownership

Profit

Certified

May 4, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

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
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

Practitioners 1

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

• Robert Bradley Canada, MD

  • Nephrology Physician
  • Memphis, TN
  • NPI 1033176250
  NPD (past)

Affiliated clinicians 3

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

• Siddique Akbar, MD

  • Nephrology Physician
  • Jackson, TN
  • NPI 1295290328

  Dialysis facility

  Care Compare affiliation Name & address match
• Shree Ramakant Mulay, MD

  • Nephrology Physician
  • Dyersburg, TN
  • NPI 1548671845

  Dialysis facility

  Care Compare affiliation Name & address match
• Syed Muhammad Mohsin Raza, M.D.

  • Nephrology Physician
  • Memphis, TN
  • NPI 1992903157

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1992946131",
    "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": "854 HIGHWAY 51 S",
            "city": "RIPLEY",
            "state": "TN",
            "postal_code": "380635536",
            "telephone_number": "731-221-1883",
            "fax_number": "731-221-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIPLEY DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "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": "0442696",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ripley Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ripley Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Revelle Rains, PHYSICIAN ASSISTANT
• Reese Private Care Inc
• Brenda Renea Reese
• Lauren Renfrow, LPN
• Denise Naylor Rhodes, LPN
• Ripley Drugs, LLC
• Ripley Medical Clinic Inc
• Ripley Operator LLC
• Ripley Residential, LLC
• Rural Health Clinics of West TN PLLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ripley, TN
• Providers in Ripley, TN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.