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DEGRAY DIALYSIS
NPI 1184968604
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Arkadelphia, AR

Active since November 21, 2012CLIA 04D0466009 · Waiver
3/5
Overall Rating
312 PROFESSIONAL PARK DR STE H, ARKADELPHIA, AR 71923(870) 246-3021(870) 245-3766 Get Directions Write a Review

NPPES record last updated: January 17, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 29, 2022, Nov 9, 2022, Sep 3, 2020 and 2 more (5 updates tracked since 2018).

About Degray Dialysis NPPES

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

DEGRAY DIALYSIS (NPI 1184968604) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Arkadelphia, Arkansas and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through June 7, 2027 and lists Samuel T Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1184968604
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameRENAL TREATMENT CENTERS-SOUTHEAST, LP.
Location Address312 PROFESSIONAL PARK DR STE HArkadelphia, AR 71923-5355
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569 · (615) 320-4268 · Fax (877) 238-0567
Phone(870) 246-3021
Fax(870) 245-3766
Organization SubpartNo
Authorized OfficialSamuel T WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateNovember 21, 2012
Last NPPES UpdateJanuary 17, 20245 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2024
✔ NPI 1184968604 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
312 PROFESSIONAL PARK DR STE H, Arkadelphia, AR 71923
Open in Google Maps ↗

Other Names 1

Doing Business AsDegray Dialysis

Other Identifiers 1

Medicaid201693134AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.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 04D0466009

Degray Dialysis · Arkadelphia, AR
Active · expires Jun 7, 2027
CLIA Number04D0466009
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateJune 8, 2025
Certificate Expiration DateJune 7, 2027
Laboratory DirectorMichael S. Gersch
Laboratory Phone(870) 246-3021
Laboratory LocationDegray Dialysis312 Professional Park Drive, Suite H, Arkadelphia, AR 71923
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for DaVita Degray Dialysis (CMS certification number 042512), from CMS Care Compare.

DaVita Degray Dialysis

Dialysis facility · Arkadelphia, AR
3/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number042512
ESRD NetworkNetwork 13
Hemodialysis Stations17
Medicare-Certified SinceSeptember 12, 1986
Location312 PROFESSIONAL PARK DR STE HArkadelphia, AR 71923 · Clark County
Phone(870) 246-3021
Services Offered
In-center hemodialysis Peritoneal dialysis

Frequently Asked Questions

What is RENAL TREATMENT CENTERS-SOUTHEAST, LP.'s NPI number?

The NPI number assigned to this healthcare provider is 1184968604, enumerated as an "organization" on November 21, 2012.

Where is the provider located?

The provider is located at 312 PROFESSIONAL PARK DR STE H ARKADELPHIA, AR 71923 and the phone number is (870) 246-3021.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QE0700X and a focus in End-Stage Renal Disease (ESRD) Treatment.

What insurance does RENAL TREATMENT CENTERS-SOUTHEAST, LP. accept?

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.