MEDICARE: CADDOAN DIALYSIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1306381942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CADDOAN DIALYSIS LLC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	ATT: L&C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2852 W 47TH AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-3243
Country	:	US
Telephone Number	:	913-403-1843
Fax Number	:	913-403-1848

Authorized Official
Title or Position	:	VP LICENSURE & CERTIFICATION
Name	:	SAMUEL T WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	01/05/2017
Last Update Date	:	05/15/2025

Similar Medicare Providers

1811438013 — LAUREN VICTORIA PORTER HUGHES MD
Practice Location Address:

2870 W 47TH AVE
KANSAS CITY, KS
66103-3243

Practice Phone: 913-735-3551
Practice Fax:

1720728355 — DR. JORDAN MARSHALL STRICKLER MD
Practice Location Address:

2870 W 47TH AVE
KANSAS CITY, KS
66103-3243

Practice Phone: 913-735-3551
Practice Fax: 813-537-8836

1144101957 — BAYLIE DOYAL PT
Practice Location Address:

2872 W 47TH AVE
KANSAS CITY, KS
66103-3243

Practice Phone: 913-728-6158
Practice Fax:

1992781157 — PIERRE PODREBARAC MD
Practice Location Address:

2790 CLAY EDWARDS DR STE 500
NORTH KANSAS CITY, MO
64116-3243

Practice Phone: 816-468-8820
Practice Fax: 816-468-8898

1245670637 — DR. JAMES ALLAN GAUNT D.O.
Practice Location Address:

2790 CLAY EDWARDS DR STE 500
NORTH KANSAS CITY, MO
64116-3243

Practice Phone: 816-994-0040
Practice Fax: 816-994-0044

1144610049 — LARISSA GASAWAY APRN
Practice Location Address:

2790 CLAY EDWARDS DR STE 500
NORTH KANSAS CITY, MO
64116-3243

Practice Phone: 816-994-0040
Practice Fax: 816-994-0044

Directions to “CADDOAN DIALYSIS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.