WICKENBURG DIALYSIS
NPI 1093071821
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Wickenburg, AZ

Active since April 05, 2012CLIA 03D2041753 · Waiver
811 N TEGNER ST, SUITES 101, 103, 105, 107, WICKENBURG, AZ 85390(928) 684-6898(928) 684-6107 Get Directions Write a Review

NPPES record last updated: January 2, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 2, 2025, Apr 18, 2022, Mar 6, 2019 and 2 more (5 updates tracked since 2016).

About Wickenburg Dialysis NPPES

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

WICKENBURG DIALYSIS (NPI 1093071821) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Wickenburg, Arizona and active in the NPI registry since April 2012. The organization holds a CLIA Waiver certificate valid through May 28, 2028 and lists Samuel T Wey, Vp, Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1093071821
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameSOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC
Location Address811 N TEGNER ST, SUITES 101, 103, 105, 107Wickenburg, AZ 85390-5409
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Fax(928) 684-6107
Organization SubpartNo
Authorized OfficialSamuel T WeyVp, Licensure & Certification · (615) 341-6641
Enumeration DateApril 5, 2012
Last NPPES UpdateJanuary 2, 20255 updates tracked since enumeration
NPPES CertifiedJanuary 2, 2025
NPI 1093071821 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
811 N TEGNER ST, Wickenburg, AZ 85390

Other Names 1

Doing Business AsWickenburg Dialysis

Other Identifiers 1

Medicaid787101AZ

Accepted Insurance

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 Waiver 03D2041753

Wickenburg Dialysis · Wickenburg, AZ
Active · expires May 28, 2028
CLIA Number03D2041753
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateMay 29, 2026
Certificate Expiration DateMay 28, 2028
Laboratory DirectorNandini P. Sharma
Laboratory Phone(928) 684-6898
Laboratory LocationWickenburg Dialysis811 N Tegner St Ste 101, Wickenburg, AZ 85390
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

Family Medicine
811 N TEGNER ST, SUITE 113
WICKENBURG, AZ 85390
Radiology (Diagnostic Radiology)
811 N TEGNER ST, SUITE 105
WICKENBURG, AZ 85390
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
811 N TEGNER ST, SUITES 101, 103, 105, 107
WICKENBURG, AZ 85390

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 Southwest Kidney Davita Dialysis Partners LLC's NPI number?

The NPI number for Southwest Kidney Davita Dialysis Partners LLC is 1093071821. It was assigned to this organization in the NPPES registry on April 5, 2012. The provider is doing business as Wickenburg Dialysis.

Where is Southwest Kidney Davita Dialysis Partners LLC located?

Southwest Kidney Davita Dialysis Partners LLC is located at 811 N Tegner St Suites 101, 103, 105, 107, Wickenburg, AZ 85390. The listed phone number is (928) 684-6898.

What is Southwest Kidney Davita Dialysis Partners LLC'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 Southwest Kidney Davita Dialysis Partners LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2041753) is associated with this NPI, valid through May 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southwest Kidney Davita Dialysis Partners LLC accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc., Oscar Health Insurance and Oscar Health Maintenance Organization of Florida and 4 other insurers list Southwest Kidney Davita Dialysis Partners LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southwest Kidney Davita Dialysis Partners LLC was last updated on January 2, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.