North Davidson Dialysis Center of Wake Forest University

Primary specialty

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

Legal business name

NORTH DAVIDSON DIALYSIS CENTER OF WAKE FOREST UNIVERSITY

Doing business as

North Davidson Dialysis Center

Practice address

295 Millers Creek Dr
Winston Salem, NC 27127-8923

Phone

(336) 793-0195

Fax

(336) 793-0415

NPI assigned

Oct 8, 2020

Last updated

Feb 9, 2026By the provider in NPPES

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

• North Davidson Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

North Davidson Dialysis Center of Wake Forest UniversityCCN 342767

Overall star rating

3.0 of 5

Ownership

Non-profit

Certified

Jun 27, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Other

Dialysis stations

19

Member of 1

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

• Wake Forest University Health Sciences

  • Ophthalmology Physician
  • Greensboro, NC
  • NPI 1225139249

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin High, MD

  • Infectious Disease Physician
  • Winston Salem, NC
  • NPI 1144205428
  NPD
• Russell Mars Howerton, MD

  • Surgery Physician
  • Winston Salem, NC
  • NPI 1932184066
  NPD (past)

Affiliated clinicians 3

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

• Deanna Nicole Jones, M.D.

  • Nephrology Physician
  • Winston Salem, NC
  • NPI 1760893051

  Dialysis facility

  Care Compare affiliation Name & address match
• Nicholas Oliver McLean, MD

  • Nephrology Physician
  • Winston Salem, NC
  • NPI 1205193331

  Dialysis facility

  Care Compare affiliation Name & address match
• Scott Gregory Satko, MD

  • Nephrology Physician
  • Winston Salem, NC
  • NPI 1962487397

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1821695164",
    "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": "295 MILLERS CREEK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271278923",
            "telephone_number": "336-793-0195",
            "fax_number": "336-793-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DAVIDSON DIALYSIS CENTER OF WAKE FOREST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821695164",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Davidson Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• North Carolina Digital Imaging, Inc
• North Carolina General Management LLC (Clinica San Felipe Winston-Salem)
• North Carolina Inpatient Medicine Associates, PLLC
• North Carolina Mobiel Ultrasound,Inc
• North Carolina Sports Medicine Institute PLLC
• North Point Dental Care
• James Matthew North, MD
• Rod North, LCSW
• Northland Hearing Centers, Inc. (NuEar Hearing Center)
• Lauren Alexandra Northrup, CCC, SLP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• 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.