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Southlake Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Broken Arrow, OK · enumerated 2012 · authorized official Samuel Wey, Vp Licensure & Certification.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1568708279

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Registry record

Entity type Organization (Type 2)
Legal business name Southlake Dialysis LLC
Other name <Unavail>
Practice address 1710 N 9th St, Broken Arrow, OK, 74012
Phone (918) 355-0657
Fax (918) 355-2800
Enumeration date Dec 27, 2012
Last updated in NPPES May 1, 2025

Taxonomy & classification

261QE0700X End-Stage Renal Disease (ESRD) Treatment Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Samuel Wey
Title Vp Licensure & Certification
Phone (615) 341-6641

Other identifiers

Identifier Type State Issuer
200509720A Medicaid OK -

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.

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Frequently asked questions

Who is the authorized official for Southlake Dialysis LLC?
NPPES lists Samuel Wey (Vp Licensure & Certification) as the authorized official for this organization.
What is the NPI number for Southlake Dialysis LLC?
The NPI for Southlake Dialysis LLC is 1568708279, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-05-01.