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LOOMIS ROAD DIALYSIS
NPI 1720042559
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Greenfield, WI

Active since April 17, 2006CLIA 52D0391433 · Waiver
2/5
Overall Rating
4120 W LOOMIS RD, GREENFIELD, WI 53221(414) 761-4920(414) 761-4926 Get Directions Write a Review

NPPES record last updated: September 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 12, 2024, Apr 15, 2021, Sep 11, 2019 (3 updates tracked since 2019).

About Loomis Road Dialysis NPPES

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

LOOMIS ROAD DIALYSIS (NPI 1720042559) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Greenfield, Wisconsin and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Samuel T Wey, Vp Licensure & Certification, as its authorized official.

NPPES Registry Identity

NPI1720042559
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameDVA RENAL HEALTHCARE INC
Location Address4120 W LOOMIS RDGreenfield, WI 53221-2052
Mailing Address5200 Virginia Way, L&c DeptBrentwood, TN 37027-7569
Phone(414) 761-4920
Fax(414) 761-4926
Organization SubpartNo
Authorized OfficialSamuel T WeyVp Licensure & Certification · (615) 341-6641
Enumeration DateApril 17, 2006
Last NPPES UpdateSeptember 12, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 12, 2024
✔ NPI 1720042559 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
4120 W LOOMIS RD, Greenfield, WI 53221
Open in Google Maps ↗

Other Names 1

Doing Business AsLoomis Road Dialysis

Other Identifiers 1

Medicaid1720042559WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Quartz 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 52D0391433

Loomis Road Dialysis · Greenfield, WI
Active · expires Aug 31, 2026
CLIA Number52D0391433
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDr. Ajjampur R. Vidyaranya
Laboratory Phone(414) 761-4920
Laboratory LocationLoomis Road Dialysis4120 W Loomis Rd, Greenfield, WI 53221
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 Loomis Road Dialysis (CMS certification number 522507), from CMS Care Compare.

DaVita Loomis Road Dialysis

Dialysis facility · Greenfield, WI
2/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainDaVita
CMS Certification Number522507
ESRD NetworkNetwork 11
Hemodialysis Stations21
Medicare-Certified SinceMarch 22, 1989
Location4120 W LOOMIS RDGreenfield, WI 53221 · Milwaukee County
Phone(414) 761-4920
Services Offered
In-center hemodialysis Home hemodialysis training

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 DVA Renal Healthcare Inc's NPI number?

The NPI number for DVA Renal Healthcare Inc is 1720042559. It was assigned to this organization in the NPPES registry on April 17, 2006. The provider is doing business as Loomis Road Dialysis.

Where is DVA Renal Healthcare Inc located?

DVA Renal Healthcare Inc is located at 4120 W Loomis Rd, Greenfield, WI 53221. The listed phone number is (414) 761-4920.

What is DVA Renal Healthcare 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 DVA Renal Healthcare Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0391433) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is DVA Renal Healthcare Inc a Medicare-certified dialysis facility?

Yes. DaVita Loomis Road Dialysis is a Medicare-certified dialysis facility, certified since March 22, 1989.

What quality rating does DVA Renal Healthcare Inc have?

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

What insurance does DVA Renal Healthcare Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, HealthPartners, Quartz and UnitedHealthcare list DVA Renal Healthcare 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 DVA Renal Healthcare Inc was last updated on September 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.