Shade Dialysis LLC
Shade Dialysis LLC is a healthcare organization registered as End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wagoner, OK, holding Type 2 (organization) NPI 1215483862 since 2016. The authorized official on file is Samuel Wey, Vp, Licensure & Certification.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1215483862 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Shade Dialysis LLC |
| Other name | <Unavail> |
| Practice address | 402 SOUTH WALL STREET, Wagoner, OK, 74467 |
| Phone | 9184854363 |
| Fax | 9184853043 |
| Enumeration date | 2016-09-01 |
| Last updated in NPPES | 2025-08-25 |
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 |
|---|---|---|---|
| 200748420A | Medicaid | OK | — |
Copy-ready billing details
Provider: Shade Dialysis LLC NPI: 1215483862 Taxonomy: 261QE0700X (End-Stage Renal Disease (ESRD) Treatment Clinic/Center) Address: 402 SOUTH WALL STREET, Wagoner, OK, 74467
Verify this record
Cross-check NPI 1215483862 against the authoritative CMS record: view Shade Dialysis LLC 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
What is a Type 2 NPI?
What type of organization is Shade Dialysis LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-08-25.