Elkin Dialysis Center of Wake Forest University

Primary specialty

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

Legal business name

ELKIN DIALYSIS CENTER OF WAKE FOREST UNIVERSITY

Practice address

941 Johnson Ridge Rd
Elkin, NC 28621-2211

Phone

(336) 527-4722

Fax

(336) 527-4610

NPI assigned

Dec 29, 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

• Elkin Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

Elkin Dialysis CenterCCN 342614

Overall star rating

3.0 of 5

Ownership

Non-profit

Certified

Dec 21, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Wake Forest University

Dialysis stations

19

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

Practitioners 1

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

• Julie A Freischlag, M.D.

  • Vascular Surgery Physician
  • Winston Salem, NC
  • NPI 1730127614
  NPD (past)

Affiliated clinicians 2

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

• Denise H. Laurienti, M.D.

  • Nephrology Physician
  • Winston-Salem, NC
  • NPI 1023017563

  Dialysis facility

  Care Compare affiliation Name & address match
• Taewoo Lee, MD, PHD

  • Nephrology Physician
  • Winston Salem, NC
  • NPI 1033649819

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1477530525",
    "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": "941 JOHNSON RIDGE RD",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212211",
            "telephone_number": "336-527-4722",
            "fax_number": "336-527-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKIN DIALYSIS CENTER OF WAKE FOREST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "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": "3402614",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elkin Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Josh R Edwards, DPT
• Susan T Edwards, ANP
• Elizabeth Eidson
• Elk Pharmacy Inc
• Elkin City Schools
• Elkin Emergency Physicians, PLLC
• Elkin Emergency Rescue Squad, Inc.
• Elkin Obstetrics and Gynecology, PLLC
• Elkin Pediatric & Adult Medicine, PA
• Elkin Retirement Community, LLC

• All providers in Elkin, 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.