DAVIE KIDNEY CENTER OF WAKE FOREST UNIVERSITY (NPI# 1932421427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932421427 |
| Entity Type | Organization |
| Organization Name | DAVIE KIDNEY CENTER OF WAKE FOREST UNIVERSITY |
| Other Organization Name | DAVIE KIDNEY CENTER |
| Practice Address |
190 Interstate Drive Mocksville NC 27028 |
| Mailing Address |
Po Box 7710 Tifton GA 31793-7710 |
| Practice Telephone | 3367531210 |
| Practice Fax Number | 3367531529 |
| Mailing Telephone | 2293873527 |
| Mailing Fax Number | 2293862149 |
| Enumeration Date | 2010-02-24 |
| 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 |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3402677 | 05 |
| Other Name | Type Code |
|---|---|
| Davie Kidney Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Davie Kidney Center of Wake Forest University | Medical Center Boulevard, Winston Salem, NC 27157-1035 |
| Street Address |
190 INTERSTATE DRIVE |
| City | MOCKSVILLE |
| State | NC |
| Zip Code | 27028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285270868 | Gaston Family Health Services, Inc. | Clinic/Center | 160 Martin Luther King Junior Rd, Mocksville, NC 27028 | 2019-11-19 |
| 1730649633 | Dawn Michelle Whitsel | Occupational Therapy Assistant | 498 Madison Rd., Mocksville, NC 27028 | 2019-03-25 |
| 1912476391 | Warren Hearing Solutions, LLC | Audiologist-Hearing Aid Fitter | 189 Gaither St, Mocksville, NC 27028 | 2018-11-15 |
| 1548711385 | Tyler Crane | Nurse Practitioner | 375 Hospital St Ste 200, Mocksville, NC 27028 | 2016-10-17 |
| 1679926042 | Nicholas Martyak | Physical Therapist | 161 Nikkis Way, Mocksville, NC 27028 | 2016-07-20 |
| 1386987790 | Elizabeth Hemmings | Speech-Language Pathologist | 498 Madison Road, Mocksville, NC 27028 | 2013-04-03 |
| 1568455707 | Wake Forest University Baptist Medical Center Community Physicians | Pediatrics | 113 Marketplace Drive, Mocksville, NC 27028 | 2005-08-23 |
| 1912485517 | Davie Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 498 Madison Road, Mocksville, NC 27028 | 2018-08-06 |
| 1245747062 | Emma Beneke | Social Worker | 172 S Clement St, Mocksville, NC 27028 | 2018-01-02 |
| 1417345315 | Emily Draughn Collette | Nurse Practitioner | 485 Valley Rd, Mocksville, NC 27028 | 2014-12-30 |
| Find all providers in zip 27028 | ||||
| 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 |
|---|---|---|---|---|
| 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 | MOCKSVILLE |
| Zip Code | 27028 |
Please comment or provide details below to improve the information on DAVIE 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.