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WK RENAL DIALYSIS
NPI 1003020579
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Shreveport, LA

Active since May 10, 2007CLIA 19D0463554 · Accreditation
3/5
Overall Rating
1111 LINE AVENUE, SHREVEPORT, LA 71101(318) 212-4759 Get Directions Write a Review

NPPES record last updated: January 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 8, 2025, Feb 17, 2017 (2 updates tracked since 2017).

About Wk Renal Dialysis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WK RENAL DIALYSIS (NPI 1003020579) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Shreveport, Louisiana and active in the NPI registry since May 2007. The organization holds an CLIA Accreditation certificate valid through February 27, 2027 and lists Mary Jane Ward, Cfo, as its authorized official.

NPPES Registry Identity

NPI1003020579
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameWILLIS KNIGHTON MEDICAL CENTER, INC.
Location Address1111 LINE AVENUEShreveport, LA 71101
Mailing Address2600 Greenwood RdShreveport, LA 71103-3908
Phone(318) 212-4759
Organization SubpartNo
Authorized OfficialMary Jane WardCfo · (318) 212-4384
Enumeration DateMay 10, 2007
Last NPPES UpdateJanuary 8, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 8, 2025
✔ NPI 1003020579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
1111 LINE AVENUE, Shreveport, LA 71101
Open in Google Maps ↗

Other Names 1

Doing Business AsWk Renal Dialysis

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 19D0463554

Willis-Knighton Medical Center · Shreveport, LA
Active · expires Feb 27, 2027
CLIA Number19D0463554
Laboratory TypeHospital
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorDr. Matthew B. Mastrodomenico
Laboratory Phone(318) 212-8368
Laboratory LocationWillis-Knighton Medical Center2600 Greenwood Road Attn Laboratory, Shreveport, LA 71103
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for Willis Knighton Med Ctr-Dialysis (CMS certification number 192308), from CMS Care Compare.

Willis Knighton Med Ctr-Dialysis

Dialysis facility · Shreveport, LA
3/5 CMS RatingRating period January 2020 to December 2023
OwnershipNon-profit
CMS Certification Number192308
ESRD NetworkNetwork 13
Hemodialysis Stations13
Medicare-Certified SinceJune 12, 1989
Location1111 Line AvenueShreveport, LA 71101 · Caddo County
Phone(318) 716-4555
Services Offered
In-center hemodialysis

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIS KNIGHTON MEDICAL CENTER, INC.
Rehabilitation Unit
1111 LINE AVENUE
SHREVEPORT, LA 71101
Caddo Parish (318) 212-4877
WILLIS KNIGHTON MEDICAL CENTER, INC.
Psychiatric Unit
1111 LINE AVENUE
SHREVEPORT, LA 71101
Caddo Parish (318) 212-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willis Knighton Medical Center, Inc.'s NPI number?

The NPI number for Willis Knighton Medical Center, Inc. is 1003020579. It was assigned to this organization in the NPPES registry on May 10, 2007. The provider is doing business as Wk Renal Dialysis.

Where is Willis Knighton Medical Center, Inc. located?

Willis Knighton Medical Center, Inc. is located at 1111 Line Avenue, Shreveport, LA 71101. The listed phone number is (318) 212-4759.

What is Willis Knighton Medical Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Willis Knighton Medical Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 19D0463554) is associated with this NPI, valid through February 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Willis Knighton Medical Center, Inc. a Medicare-certified dialysis facility?

Yes. Willis Knighton Med Ctr-Dialysis is a Medicare-certified dialysis facility, certified since June 12, 1989.

What quality rating does Willis Knighton Medical Center, Inc. have?

CMS rates Willis Knighton Med Ctr-Dialysis 3 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

When was this NPI record last updated?

The NPPES record for Willis Knighton Medical Center, Inc. was last updated on January 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.