Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northside Dialysis Center of Wake Forest University

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1114904133

Northside Dialysis Center of Wake Forest University is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Winston Salem, North Carolina. Medicare rates this dialysis facility 1 out of 5. Licensed in North Carolina.

CMS rating
1 of 5
Licensed in
NC
In the registry since
2005

CMS quality rating

1 out of 5 — official dialysis facility rating from CMS Care Compare (CCN 342612)

Practice location Address checks out

500 W Hanes Mill Rd
Winston Salem, NC 27105-9814
Phone: (336) 744-0577
Fax: (336) 744-9021
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary) Taxonomy 261QE0700X (NC)

Record details

NPI number1114904133
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Johnson — Credentialing Coord. · (229) 387-3528
Other names Northside Dialysis Center
NPI enumeratedDecember 30, 2005
Last updated in NPPESFebruary 9, 2026
Certification dateFebruary 9, 2026
Mailing addressPo Box 7350, Tifton, GA 31793-7350

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