MATTAPAN DIALYSIS LLC NPI 1386298560

NPI Information

  • NPI: 1386298560
  • Provider Name: MATTAPAN DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • :
  • CLIA Number: 44D2171161
  • Address: 5144 RIVERDALE RD STE 103
    MEMPHIS, TN
    ZIP 38141
  • Phone: (901) 752-5425

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NPI Details

MATTAPAN DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Memphis, TN. MATTAPAN DIALYSIS LLC NPI is 1386298560. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

5144 RIVERDALE RD STE 103
MEMPHIS, TN
ZIP 38141-271
Phone: (901) 752-5425
Fax: (901) 752-5516

The provider's authorized official is Samuel T 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 44D2171161 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/26/2019 and was last updated on 5/14/2025.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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: 11/21/2025

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