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SHADE DIALYSIS LLC
NPI 1215483862
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Wagoner, OK

Active since September 01, 2016
2/5
Overall Rating
402 SOUTH WALL STREET, WAGONER, OK 74467(918) 485-4363(918) 485-3043 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 12, 2024, Nov 2, 2023, Oct 13, 2023 and 4 more (7 updates tracked since 2016).

About Shade Dialysis Llc NPPES

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

SHADE DIALYSIS LLC (NPI 1215483862), doing business as Wagoner Dialysis, is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Wagoner, Oklahoma and active in the NPI registry since September 2016. The organization lists Samuel T Wey, Vp, Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1215483862
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameSHADE DIALYSIS LLC
Location Address402 SOUTH WALL STREETWagoner, OK 74467-5003
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Phone(918) 485-4363
Fax(918) 485-3043
Organization SubpartNo
Authorized OfficialSamuel T WeyVp, Licensure & Certification · (615) 341-6641
Enumeration DateSeptember 1, 2016
Last NPPES UpdateAugust 25, 20257 updates tracked since enumeration
NPPES CertifiedAugust 25, 2025
✔ NPI 1215483862 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
402 SOUTH WALL STREET, Wagoner, OK 74467
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Other Names 1

Doing Business AsWagoner Dialysis

Other Identifiers 1

Medicaid200748420AOK

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 Sunflower Health Plan and more.Insurance ›

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for DaVita Wagoner Dialysis (CMS certification number 372606), from CMS Care Compare.

DaVita Wagoner Dialysis

Dialysis facility · Wagoner, OK
2/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number372606
ESRD NetworkNetwork 13
Hemodialysis Stations13
Medicare-Certified SinceJune 28, 2017
Location402 S WALL STREETWagoner, OK 74467 · Wagoner County
Phone(918) 485-4363
Services Offered
In-center hemodialysis Peritoneal dialysis

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 Shade Dialysis LLC's NPI number?

The NPI number for Shade Dialysis LLC is 1215483862. It was assigned to this organization in the NPPES registry on September 1, 2016. The provider is doing business as Wagoner Dialysis.

Where is Shade Dialysis LLC located?

Shade Dialysis LLC is located at 402 South Wall Street, Wagoner, OK 74467. The listed phone number is (918) 485-4363.

What is Shade Dialysis 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.

Is Shade Dialysis LLC a Medicare-certified dialysis facility?

Yes. DaVita Wagoner Dialysis is a Medicare-certified dialysis facility, certified since June 28, 2017.

What quality rating does Shade Dialysis LLC have?

CMS rates DaVita Wagoner Dialysis 2 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Shade Dialysis LLC accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter from Superior HealthPlan and 10 other insurers list Shade Dialysis 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 Shade Dialysis LLC was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.