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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DVA WASHINGTON UNIVERSITY HEALTHCARE OF GREATER ST LOUIS LLC
NPI 1962344234
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Florissant, MO

Active since April 07, 2026
272 MAYFAIR PLAZA SHOPPING CTR, FLORISSANT, MO 63033(314) 859-1234 Get Directions Write a Review

NPPES record last updated: June 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dva Washington University Healthcare Of Greater St Louis Llc NPPES

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

DVA WASHINGTON UNIVERSITY HEALTHCARE OF GREATER ST LOUIS LLC (NPI 1962344234), doing business as Black Jack Dialysis, is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Florissant, Missouri and active in the NPI registry since April 2026. The organization lists Sam T Wey, Vp, Licensure And Certification, as its authorized official.

NPPES Registry Identity

NPI1962344234
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameDVA WASHINGTON UNIVERSITY HEALTHCARE OF GREATER ST LOUIS LLC
Location Address272 MAYFAIR PLAZA SHOPPING CTRFlorissant, MO 63033-8009
Mailing Address5200 Virginia Way, Licensure And Certification DeptBrentwood, TN 37027-7569
Phone(314) 859-1234
Organization SubpartYesParent: Davita Inc
Authorized OfficialSam T WeyVp, Licensure And Certification · (615) 341-6691
Enumeration DateApril 7, 2026
Last NPPES UpdateJune 22, 2026
NPPES CertifiedJune 22, 2026
✔ NPI 1962344234 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
272 MAYFAIR PLAZA SHOPPING CTR, Florissant, MO 63033
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Other Names 1

Doing Business AsBlack Jack Dialysis

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.

MR. THOMAS FANCIS GOWEN JR. RN
Registered Nurse (Nephrology)
272 MAYFAIR PLAZA SHOPPING CTR
FLORISSANT, MO 63033
St. Louis County (314) 859-1234
MR. ALEX JAMES STARK-VALDEZ FNP
Nurse Practitioner (Family)
272 MAYFAIR PLAZA SHOPPING CTR
FLORISSANT, MO 63033
St. Louis County (314) 859-1234
WASHINGTON UNIVERSITY
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
272 MAYFAIR PLAZA SHOPPING CTR
FLORISSANT, MO 63033
St. Louis County (314) 859-1234

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 Washington University Healthcare Of Greater St Louis LLC's NPI number?

The NPI number for DVA Washington University Healthcare Of Greater St Louis LLC is 1962344234. It was assigned to this organization in the NPPES registry on April 7, 2026. The provider is doing business as Black Jack Dialysis.

Where is DVA Washington University Healthcare Of Greater St Louis LLC located?

DVA Washington University Healthcare Of Greater St Louis LLC is located at 272 Mayfair Plaza Shopping Ctr, Florissant, MO 63033. The listed phone number is (314) 859-1234.

What is DVA Washington University Healthcare Of Greater St Louis 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.

When was this NPI record last updated?

The NPPES record for DVA Washington University Healthcare Of Greater St Louis LLC was last updated on June 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 47 days 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.