Organization Active NPI

Highland Oaks Dialysis Center of Wake Forest University

Doing business as Highland Oaks Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1083287379
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
HIGHLAND OAKS DIALYSIS CENTER OF WAKE FOREST UNIVERSITY
Doing business as
Highland Oaks Dialysis Center
Practice address
730 Highland Oaks Dr Ste 101
Winston Salem, NC 27103-7108
Phone
(336) 793-0189
Fax
(336) 793-0275
NPI assigned
Jul 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kimberly Agee-Clark Johnson, MBA
Title
Credentialing Coord.
Phone
(229) 387-3528

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

730 Highland Oaks Dr Ste 101
Winston Salem, NC 27103-7108

Mailing address

PO Box 7350
Tifton, GA 31793-7350
Phone (229) 387-3528

Other identifiers 1

IdentifierTypeStateIssuer
1083287379MedicaidNC

Other names 1

  • Highland Oaks Dialysis Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220330002053 NC Part A Provider - End-Stage Renal Disease Facility (ESRD) 0547656522 Practice locations: Winston Salem, NC

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Highland Oaks Dialysis CenterCCN 342768
Overall star rating
4.0 of 5
Ownership
Non-profit
Certified
Sep 20, 2022
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Wake Forest University
Dialysis stations
1

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2237292Highland Oaks Dialysis Center of Wake730 Highland Oaks Drive, Ste 101, Winston-Salem, NC 27103Certificate of waiverSep 22, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

730 Highland Oaks Dr
Ste 101
Winston Salem, NC 27103
Phone (336) 765-6897

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1083287379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7350",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317937350",
            "telephone_number": "229-387-3528",
            "fax_number": "229-386-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 HIGHLAND OAKS DR STE 101",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037108",
            "telephone_number": "336-793-0189",
            "fax_number": "336-793-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND OAKS DIALYSIS CENTER OF WAKE FOREST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "AGEE-CLARK",
        "authorized_official_title_or_position": "CREDENTIALING COORD.",
        "authorized_official_telephone_number": "229-387-3528",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083287379",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Oaks Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.