Isd Renal Inc
Isd Renal Inc is a healthcare organization registered as End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Rolla, MO, holding Type 2 (organization) NPI 1063923753 since 2017. The authorized official on file is Samuel Wey, Vp Licensure & Certification.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1063923753 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Isd Renal Inc |
| Other name | <Unavail> |
| Practice address | 1702 E 10TH ST STE B, Rolla, MO, 65401 |
| Phone | 5734582013 |
| Fax | 5734582094 |
| Enumeration date | 2017-10-20 |
| Last updated in NPPES | 2026-03-04 |
Authorized official
| Name | Samuel Wey |
|---|---|
| Title | Vp Licensure & Certification |
| Phone | 6153416641 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QE0700X | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500060490 | Medicaid | MO | — |
Copy-ready billing details
Provider: Isd Renal Inc NPI: 1063923753 Taxonomy: 261QE0700X (End-Stage Renal Disease (ESRD) Treatment Clinic/Center) Address: 1702 E 10TH ST STE B, Rolla, MO, 65401
Verify this record
Cross-check NPI 1063923753 against the authoritative CMS record: view Isd Renal Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Isd Renal Inc?
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2026-03-04.