Southlake Dialysis LLC
NPI 1568708279 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Broken Arrow, OK
Enrolled with Medicare as Part a Provider - End-Stage Renal Disease Facility (esrd) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southlake Dialysis LLC is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center organization in Broken Arrow, OK (NPI 1568708279).
Provider details
- NPI number
- 1568708279
- 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
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
Mailing address
Other names (DBA / former)
- Doing business as
- Broken Arrow Dialysis Center
Registry dates
- Enumerated
- 2012-12-27
- Last updated
- 2025-05-01
- Certified
- 2025-05-01
Frequently asked questions
- What is Southlake Dialysis LLC's NPI number?
- Southlake Dialysis LLC's National Provider Identifier (NPI) is 1568708279, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southlake Dialysis LLC?
- Southlake Dialysis LLC is classified in the NPPES registry as End-Stage Renal Disease (ESRD) Treatment Clinic/Center (Ambulatory Health Care Facilities).
- Where is Southlake Dialysis LLC located?
- Southlake Dialysis LLC's practice location on file with NPPES is 1710 N 9th St, Broken Arrow, OK 74012-8283.
- What is Southlake Dialysis LLC's phone number?
- The practice phone number listed in the NPPES registry for Southlake Dialysis LLC is (918) 355-0657.
- Does Southlake Dialysis LLC accept Medicare?
- Southlake Dialysis LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southlake Dialysis LLC?
- The authorized official listed on Southlake Dialysis LLC's NPPES record is Samuel Wey, Vp Licensure & Certification. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southlake Dialysis LLC's NPI active?
- Yes — Southlake Dialysis LLC's NPI (1568708279) is active in the NPPES registry as of the last update on 2025-05-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.