Dialysis Access Group of Wake Forest University, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY, LLC

Doing business as

Dialysis Access Group

Practice address

120 Miller Street
Winston Salem, NC 27103-2500

Phone

(336) 723-1080

Fax

(336) 722-3040

NPI assigned

May 9, 2006

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 3

Other names 1

• Dialysis Access Group Doing business as

Member of 2

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

• North Carolina Baptist Hospital

  • Community/Retail Pharmacy
  • Winston Salem, NC
  • NPI 1881460855

  Member Of

  NPD member
• Wake Forest University Health Sciences

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

  Member Of

  NPD member

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1144279001",
    "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": "120 MILLER STREET",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032500",
            "telephone_number": "336-723-1080",
            "fax_number": "336-722-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "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": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916155",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144279001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905783",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dialysis Access Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barry R Deyoung, MD
• Ajay Dharod, M.D.
• Parminder Singh Dhingra, M.D.
• Yassmeen Diab
• Diabetic Home Deliveries Solution
• Clarissa Jonas Diamantidis, M.D.
• Dianne Mitchell, PH.D., PLLC
• Alexandra Anamaria Dias, D.O.
• Christopher Juan Diaz, DO
• Crystal Diaz, MD

• Nephrology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nephrology Physician 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.