Active NPI
Thomasville Dialysis Center of Wake Forest University
Doing business as Thomasville Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Thomasville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- THOMASVILLE DIALYSIS CENTER OF WAKE FOREST UNIVERSITY
- Doing business as
- Thomasville Dialysis Center
- Practice address
- 10 Laura LN
Thomasville, NC 27360-5760 - Phone
- (336) 472-4500
- Fax
- (336) 472-4501
- NPI assigned
- Dec 30, 2005
- Last updated
- Feb 9, 2026
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | NC | Primary |
Addresses
Primary practice location
10 Laura LN
Thomasville, NC 27360-5760
Mailing address
PO Box 7350
Tifton, GA 31793-7350
Phone (229) 387-3528
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3402639 | Medicaid | NC |
Other names 1
- Thomasville Dialysis Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040525001356 | NC | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 0749261816 | Practice locations: Thomasville, NC |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- Thomasville Dialysis Center
- Overall star rating
- Ownership
- Non-profit
- Certified
- Aug 23, 2004
- Medicare certification status
- Active
- Chain
- Wake Forest University
- Dialysis stations
- 36
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D1016847 | Thomasville Dialysis Center of Wake Forest | Certificate of waiver | Sep 9, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Asheboro, NC
- NPI 1043781990
Member Of
Locations
10 Laura Ln
Thomasville, NC 27360
Phone (336) 472-4500
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Nephrology Physician
- High Point, NC
- NPI 1518921188
Dialysis facility
NPI Registry JSON
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": "1871570812",
"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": "10 LAURA LN",
"city": "THOMASVILLE",
"state": "NC",
"postal_code": "273605760",
"telephone_number": "336-472-4500",
"fax_number": "336-472-4501"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THOMASVILLE 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": "3402639",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Thomasville Dialysis Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Thomasville, NC
- Christie Dawn Thigpen, LPN
- Thoamsville Pharmacy
- Amekia A Thomas
- Charity D Thomas
- Thomasville City Schools
- Thomasville Emergency Physicans
- Thomasville Family Pharmacy LLC (Thomasville Family Pharmacy)
- Thomasville Family Practice Associates, P.a.
- Thomasville OB-GYN Associates 2, LLC
- Thomasville OB-GYN Associates, PA
Sources for this page
- 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.