Organization · Type 2 NPI

Kingston Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Boulder, CO

NPI number 1891162301 Active

Practice location

2880 Folsom St Ste 110
Boulder, CO 80304

Call (303) 440-5600 Map

Fax (303) 440-4165

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	120301 (CO)

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1891162301
Entity type: Organization (Type 2)
Issued: Sep 1, 2015
Last updated: Jun 11, 2026
Status: Active

Other names

<unavail>
Boulder Dialysis Center · doing business as
Boulder Dialysis Center · doing business as

Authorized official

Samuel T Wey
VP Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1891162301

Kingston Dialysis LLC's National Provider Identifier is 1891162301, issued on Sep 1, 2015. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Boulder, CO. The record was last updated on Jun 11, 2026.