Organization
ISD RENAL INC
Active
Other names
Kansas City Renal Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY AO (VP, LICENSURE AND CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4601 MADISON AVE, KANSAS CITY, MO 64112-1268
(816) 764-9633
(816) 375-6351
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770539108
—
IA
05
—
200548640D
—
KS
05
—
503855900
—
MO
Enumeration date
05/26/2006
Last updated
05/12/2026
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