Individual provider Active NPI

Kimberly Lewis Agamedi, NP

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1275814758
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5005328 Issued in NC
Practice address
4555 Ogburn Ave
Winston Salem, NC 27105-2726
Phone
(336) 703-4273
Fax
(336) 661-4594
NPI assigned
Aug 29, 2011
Last updated
Jul 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5005328 NC Primary
Family Nurse Practitioner 363LF0000X 5005328 NC

Addresses

Primary practice location

4555 Ogburn Ave
Winston Salem, NC 27105-2726

Mailing address

1175 Revolution Mill Dr Ste 10
Greensboro, NC 27405-5080
Phone (336) 459-3335

Other practice location 1

1175 Revolution Mill Dr Ste 10
Greensboro, NC 27405-5080
Phone (336) 459-3335

Other names 1

  • Kimberly Lewis Wright Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111111000650 NC Practitioner - Nurse Practitioner 3870767668 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Selectwell CurrentSince Jan 28, 2024 Accepting new patients

Locations

1175 Revolution Mill Dr
Ste 10
Greensboro, NC 27405
Phone (336) 459-3335

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1275814758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 REVOLUTION MILL DR STE 10",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055080",
            "telephone_number": "336-459-3335",
            "fax_number": "336-450-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 OGBURN AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271052726",
            "telephone_number": "336-703-4273",
            "fax_number": "336-661-4594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 Revolution Mill Dr Ste 10",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274055080",
            "country_code": "US",
            "telephone_number": "336-459-3335",
            "fax_number": "336-450-1980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGAMEDI",
        "first_name": "KIMBERLY",
        "middle_name": "LEWIS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5005328",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WRIGHT",
            "middle_name": "LEWIS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.