OrganizationActive
Jacinto Dialysis LLC
NPI 1457697575 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Ardmore, OK
Provider details
- NPI number
- 1457697575
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Samuel Wey, Vp, Licensure & Certification(615) 341-6641
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2617 Crossroads Dr
Ardmore, OK 73401-2574
Phone: (580) 490-9844
Fax: (580) 490-9831
Street-level locationGet directions
Mailing address
5200 Virginia Way
Brentwood, TN 37027-7569
Other names (DBA / former)
- Doing business as
- Ardmore Dialysis Ranch
- Doing business as
- Ardmore Dialysis Ranch
Registry dates
- Enumerated
- 2012-12-18
- Last updated
- 2025-07-17
- Certified
- 2025-07-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.