PINEWOODS DIALYSIS LLC NPI 1265947477

NPI Information

NPI: 1265947477
Provider Name: PINEWOODS DIALYSIS LLC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
Doing Business As: OVERLAND PARK DIALYSIS
CLIA Number: 17D2140699
Address: 12201 W 110TH ST
OVERLAND PARK, KS
ZIP 66210
Phone: (913) 451-5984

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NPI Details

PINEWOODS DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Overland Park, KS. PINEWOODS DIALYSIS LLC NPI is 1265947477. The provider is registered as an organization entity type.
The provider Is Doing Business As Overland Park Dialysis.

The provider's business location address is:

12201 W 110TH ST
OVERLAND PARK, KS
ZIP 66210-045
Phone: (913) 451-5984
Fax: (913) 327-5401

The provider's authorized official is Samuel Wey .
The authorized official title is Vp, Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 17D2140699 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2017 and was last updated on 11/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	30004611340001	MEDICAID	KANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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