West Iredell Dialysis Center of Wake Forest University

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

WEST IREDELL DIALYSIS CENTER OF WAKE FOREST UNIVERSITY

Practice address

115 Westbrook LN
Statesville, NC 28625-2349

Phone

(704) 881-0336

Fax

(704) 881-0326

NPI assigned

Dec 30, 2005

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• West Iredell Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

West Iredell Dialysis CenterCCN 342636

Overall star rating

3.0 of 5

Ownership

Non-profit

Certified

Dec 31, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Wake Forest University

Dialysis stations

22

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

CLIA laboratory certificates

Member of 1

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

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1134731227

  Member Of

  NPD member

Affiliated clinicians 2

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

• Wolfgang Erich Lohrmann, MD

  • Nephrology Physician
  • Statesville, NC
  • NPI 1225059017

  Dialysis facility

  Care Compare affiliation Name & address match
• Sinasi Salman, MD

  • Internal Medicine Physician
  • Salisbury, NC
  • NPI 1962427823

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1124005079",
    "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": "115 WESTBROOK LN",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286252349",
            "telephone_number": "704-881-0336",
            "fax_number": "704-881-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST IREDELL DIALYSIS CENTER OF WAKE FOREST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-30",
        "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": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3402636",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Iredell Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Haley Ann Swift Wegrzyn, CNM
• Tammy L Weisner, PEER SUPPORT SPECIAL
• Myranda Welborn, B.S.
• Erica Chiodo Welch, CNM
• Eugene C Wells, MD
• Sherry West, RN
• Walter Jameson West Jr.
• Eva Wheeler, ED.S.
• Willie Roscoe Whitaker, M.D.
• Anitra D White, LPN

• All providers in Statesville, NC
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in North Carolina

• 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.