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MALLORY PARK DIALYSIS
NPI 1336682707
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Dayton, OH

Active since December 02, 2016CLIA 36D2126024 · Waiver
1/5
Overall Rating
2808 GERMANTOWN ST, DAYTON, OH 45417(937) 262-8427(937) 262-8016 Get Directions Write a Review

NPPES record last updated: June 6, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jun 6, 2024, Nov 9, 2023, Oct 6, 2022 and 2 more (5 updates tracked since 2019).

About Mallory Park Dialysis NPPES

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

MALLORY PARK DIALYSIS (NPI 1336682707) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Dayton, Ohio and active in the NPI registry since December 2016. The organization holds a CLIA Waiver certificate valid through February 16, 2027 and lists Samuel Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1336682707
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameISD RENAL INC
Location Address2808 GERMANTOWN STDayton, OH 45417-4134
Mailing Address5200 Virginia Way, Att: L&c DeptBrentwood, TN 37027-7569
Phone(937) 262-8427
Fax(937) 262-8016
Organization SubpartNo
Authorized OfficialSamuel WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateDecember 2, 2016
Last NPPES UpdateJune 6, 20245 updates tracked since enumeration
NPPES CertifiedMay 30, 2024
✔ NPI 1336682707 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
2808 GERMANTOWN ST, Dayton, OH 45417
Open in Google Maps ↗

Other Names 1

Doing Business AsMallory Park Dialysis

Other Identifiers 1

Medicaid0253536OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 36D2126024

Mallory Park Dialysis · Dayton, OH
Active · expires Feb 16, 2027
CLIA Number36D2126024
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateFebruary 17, 2025
Certificate Expiration DateFebruary 16, 2027
Laboratory DirectorSampath Thiruveedi
Laboratory Phone(937) 262-8427
Laboratory LocationMallory Park Dialysis2808 Germantown St, Dayton, OH 45417
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 Mallory Park Dialysis (CMS certification number 362860), from CMS Care Compare.

DaVita Mallory Park Dialysis

Dialysis facility · Dayton, OH
1/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number362860
ESRD NetworkNetwork 9
Hemodialysis Stations24
Medicare-Certified SinceOctober 12, 2017
Location2808 GERMANTOWN STDayton, OH 45417 · Montgomery County
Phone(937) 262-8427
Services Offered
In-center hemodialysis

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 Isd Renal Inc's NPI number?

The NPI number for Isd Renal Inc is 1336682707. It was assigned to this organization in the NPPES registry on December 2, 2016. The provider is doing business as Mallory Park Dialysis.

Where is Isd Renal Inc located?

Isd Renal Inc is located at 2808 Germantown St, Dayton, OH 45417. The listed phone number is (937) 262-8427.

What is Isd Renal 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 Isd Renal Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2126024) is associated with this NPI, valid through February 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Isd Renal Inc a Medicare-certified dialysis facility?

Yes. DaVita Mallory Park Dialysis is a Medicare-certified dialysis facility, certified since October 12, 2017.

What quality rating does Isd Renal Inc have?

CMS rates DaVita Mallory Park Dialysis 1 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Isd Renal Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 4 other insurers list Isd Renal Inc 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 Isd Renal Inc was last updated on June 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.