DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY, LLC (NPI# 1144279001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144279001 |
| Entity Type | Organization |
| Organization Name | DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY, LLC |
| Other Organization Name | DIALYSIS ACCESS GROUP |
| Practice Address |
120 Miller Street Winston Salem NC 27103-2500 |
| Mailing Address |
Po Box 20516 Winston Salem NC 27120-0516 |
| Practice Telephone | 3367231080 |
| Practice Fax Number | 3367223040 |
| Mailing Telephone | 2293873527 |
| Mailing Fax Number | 2293862149 |
| Enumeration Date | 2006-05-09 |
| 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 | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5905783 | 05 | |
| VA | 1144279001 | 05 | |
| NC | 5916155 | 05 |
| Other Name | Type Code |
|---|---|
| Dialysis Access Group | Doing Business As Name - Organization |
| Street Address |
120 MILLER STREET |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619157310 | Ravi Kiran Mallavarapu | Internal Medicine | 135 Crowne Chase Dr Apt 5, Winston Salem, NC 27104-3580 | 2007-11-09 |
| 1457452583 | Hugo A Tettamanti Md Pa | Internal Medicine | 2928 Maplewood Ave, Winston Salem, NC 27103-4021 | 2006-09-25 |
| 1275580854 | W. Scott Moore Et Al Ptr | Internal Medicine | 730 Highland Oaks Drive, Suite 201, Winston Salem, NC 27103-7108 | 2006-05-28 |
| 1962487397 | Scott Gregory Satko | Internal Medicine | 730 Highland Oaks Dr Ste 201, Winston Salem, NC 27103-7108 | 2005-12-08 |
| 1376040030 | Riti Rajendra Shah | Internal Medicine | 1 Medical Center Blvd, Winston Salem, NC 27157 | 2018-04-10 |
| 1578944013 | Andrew Henican Spangler | Internal Medicine | 730 Highland Oaks Dr Ste 201, Winston Salem, NC 27103-7108 | 2015-06-10 |
| 1851787840 | Brooke L Crossley | Internal Medicine | 730 Highland Oaks Dr Ste 201, Winston Salem, NC 27103-7108 | 2015-04-07 |
| 1588077408 | Natalia Sakhovskaya | Internal Medicine | Medical Center Blvd, Winston Salem, NC 27157 | 2014-06-09 |
| 1447676614 | Murtaza Ali Naqvi | Internal Medicine | Medical Center Blvd, Winston Salem, NC 27157-4044 | 2014-03-12 |
| 1205193331 | Nicholas Oliver Mclean | Internal Medicine | 730 Highland Oaks Dr, Winston Salem, NC 27103-7154 | 2012-04-13 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY, LLC.
| 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.