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Wake Forest University Health Sciences

Organization Active NPI Durable Medical Equipment & Medical Supplies · Asheboro, NC

NPI 1043781990 · NPPES record last updated May 1, 2025

Key facts

NPI
1043781990
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Practice address
225 W Ward St Ste 102
Asheboro, NC 27203-5423
Phone
(336) 625-3338
Fax
(336) 625-1563
NPI assigned
Dec 17, 2018
Organization subpart
No

Authorized official

Name
Ashley Carol Johnson
Title
Director, Managed Health and Enroll
Phone
(336) 713-4944

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 2,635

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 2,635

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190213001803 NC DME Supplier - Physician - Podiatry 4486564952 Practice locations: Asheboro, NC

National Provider Directory

Tax ID family
Wake Forest Univ Baptist Medical Center (45 organizations share this tax ID)

Locations

225 W Ward St
Ste 102
Asheboro, NC 27203
Phone (336) 625-3338

225 W Ward St
Asheboro, NC 27203
Phone (336) 625-3338

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

225 W Ward St Ste 102
Asheboro, NC 27203-5423

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 713-9329

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark, LLC.

Other providers in Asheboro, NC

All providers in Asheboro, NC · Durable Medical Equipment & Medical Supplies in North Carolina

Sources for this page

Verify at the official NPI Registry.