SALEM KIDNEY CENTER OF WAKE FOREST UNIVERSITY (NPI# 1114904141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114904141 |
| Entity Type | Organization |
| Organization Name | SALEM KIDNEY CENTER OF WAKE FOREST UNIVERSITY |
| Other Organization Name | SALEM KIDNEY CENTER |
| Practice Address |
2705 Boulder Park Ct Winston-salem NC 27101-4776 |
| Mailing Address |
Po Box 7710 Tifton GA 31793-7710 |
| Practice Telephone | 3367618808 |
| Practice Fax Number | 3367618864 |
| Mailing Telephone | 2293873527 |
| Mailing Fax Number | 2293862149 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2015-03-03 |
| Authorized Official Name | TERRY L HALES JR. (ASSISTANT TREASURER) |
| Authorized Official Telephone | 3367163003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
NC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3402569 | 05 | |
| NC | BCBS-NC | 0055E | 01 |
| Other Name | Type Code |
|---|---|
| Salem Kidney Center | Doing Business As Name - Organization |
| Street Address |
2705 BOULDER PARK CT |
| City | WINSTON-SALEM |
| State | NC |
| Zip Code | 27101-4776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421876 | Annie Carolina Mccollum | Occupational Therapist | 3 S Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2020-09-09 |
| 1891321337 | Philippe Ayres | Personal Emergency Response Attendant | 475 Vine St., Bowman Gray Center for Medical Education, Winston-salem, NC 27101 | 2020-03-17 |
| 1497385595 | Aereil Moore | Counselor | 655 West 4th St, Winston Salem, NC 27101 | 2020-01-17 |
| 1619519428 | Brandi Melissa Decriscio | Nurse Practitioner | 1200 N Martin Luther King Jr Drive, Winston-salem, NC 27101 | 2019-10-14 |
| 1316502909 | Burke Street Chiropractic, Pllc | Chiropractor | 1016 Burke St., Winston-salem, NC 27101 | 2019-05-08 |
| 1790349728 | Nakia Carter | Counselor | 1o1o W. Northwest Boulevard, Winston-salem, NC 27101 | 2019-04-25 |
| 1003391251 | Hannah Fortwengler Rainey | Nurse Anesthetist, Certified Registered | Medical Center Blvrd, Winston-salem, NC 27101 | 2018-10-03 |
| 1750875928 | Susan Wilhelm Patterson | Nurse Practitioner | 1200 Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2018-06-20 |
| 1194228049 | Anjanette Gilley Benjamin | Counselor | 650 Highland Ave Ste 1000, Winston Salem, NC 27101 | 2018-03-16 |
| 1376054627 | Paulisha Da-shawna Mcintyre | Social Worker | 650 Highland Ave Ste 101, Winston Salem, NC 27101 | 2017-10-13 |
| Find all providers in zip 27101 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801873831 | Piedmont Dialysis Center of Wake Forest University | Clinic/Center | 655 Cotton St, Winston-salem, NC 27101-5064 | 2005-12-30 |
| 1114904133 | Northside Dialysis Center of Wake Forest University | Clinic/Center | 500 W Hanes Mill Rd, Winston-salem, NC 27105-9814 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695164 | North Davidson Dialysis Center of Wake Forest University | Clinic/Center | 295 Millers Creek Drive, Winston Salem, NC 27127 | 2020-10-08 |
| 1730793571 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 1422 Meadowbrook Rd, Rocky Mount, NC 27801-6700 | 2020-08-31 |
| 1114546298 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 67 Jr Rd Ste 1200, Selma, NC 27576-3458 | 2020-04-09 |
| 1972139640 | Fresenius Medical Care Holly Springs, LLC | Clinic/Center | 5045 Old Raleigh Rd, Cary, NC 27511-6479 | 2020-03-13 |
| 1679106900 | Total Renal Care of North Carolina, LLC | Clinic/Center | 614 S Cannon Blvd, Kannapolis, NC 28083 | 2020-02-14 |
| 1699318162 | Total Renal Care of North Carolina, LLC | Clinic/Center | 246 Olmsted Blvd Ste E, Pinehurst, NC 28374-6005 | 2019-10-28 |
| 1497398416 | Total Renal Care of North Carolina, LLC | Clinic/Center | 2621 Hendersonville Rd, Arden, NC 28704-9226 | 2019-10-22 |
| 1780231894 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 2360 Williamwood Lane, Fayetteville, NC 28314 | 2019-08-22 |
| 1962063156 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 565 Regency Blvd, Winterville, NC 28590-5503 | 2019-06-27 |
| 1295399343 | Total Renal Care of North Carolina, LLC | Clinic/Center | 219 Martin Luther King Jr Dr, Bladenboro, NC 28320 | 2019-04-24 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON-SALEM |
| Zip Code | 27101 |
Please comment or provide details below to improve the information on SALEM KIDNEY CENTER OF WAKE FOREST UNIVERSITY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.