Northside Dialysis Center of Wake Forest University
NPI 1114904133 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Winston Salem, NC
Enrolled with Medicare as Part a Provider - End-Stage Renal Disease Facility (esrd) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Northside Dialysis Center of Wake Forest University is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center organization in Winston Salem, NC (NPI 1114904133).
Provider details
- NPI number
- 1114904133
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kimberly Johnson, Credentialing Coord.(229) 387-3528
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Northside Dialysis Center
Registry dates
- Enumerated
- 2005-12-30
- Last updated
- 2026-02-09
- Certified
- 2026-02-09
Frequently asked questions
- What is Northside Dialysis Center of Wake Forest University's NPI number?
- Northside Dialysis Center of Wake Forest University's National Provider Identifier (NPI) is 1114904133, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Northside Dialysis Center of Wake Forest University?
- Northside Dialysis Center of Wake Forest University is classified in the NPPES registry as End-Stage Renal Disease (ESRD) Treatment Clinic/Center (Ambulatory Health Care Facilities).
- Where is Northside Dialysis Center of Wake Forest University located?
- Northside Dialysis Center of Wake Forest University's practice location on file with NPPES is 500 W Hanes Mill Rd, Winston Salem, NC 27105-9814.
- What is Northside Dialysis Center of Wake Forest University's phone number?
- The practice phone number listed in the NPPES registry for Northside Dialysis Center of Wake Forest University is (336) 744-0577.
- Does Northside Dialysis Center of Wake Forest University accept Medicare?
- Northside Dialysis Center of Wake Forest University is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Northside Dialysis Center of Wake Forest University?
- The authorized official listed on Northside Dialysis Center of Wake Forest University's NPPES record is Kimberly Johnson, Credentialing Coord.. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Northside Dialysis Center of Wake Forest University's NPI active?
- Yes — Northside Dialysis Center of Wake Forest University's NPI (1114904133) is active in the NPPES registry as of the last update on 2026-02-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.