| NOVANT HEALTH INC | Winston Salem | E22 Health Care | $6.5B | 32 |
| DUKE UNIVERSITY HEALTH SYSTEM INC | Durham | E210 Health Care | $4.7B | 23 |
| DUKE UNIVERSITY | Durham | B430 Education | $3.7B | 28 |
| NORTH CAROLINA BAPTIST HOSPITAL | Winstonsalem | E220 Health Care | $3.3B | 14 |
| MOSES H CONE MEMORIAL HOSPITAL | Greensboro | E220 Health Care | $2.3B | 25 |
| WakeMed | Raleigh | E21 Health Care | $2.3B | 33 |
| STATE EMPLOYEES' CREDIT UNION | Raleigh | — | $2.2B | 24 |
| Pitt County Memorial Hospital Inc | Greenville | E220 Health Care | $2.1B | 24 |
| THE PRESBYTERIAN HOSPITAL | Winston Salem | E220 Health Care | $2B | 15 |
| SAMARITAN'S PURSE | Boone | X20 Religion-Related | $1.8B | 20 |
| GOTHIC CORPORATION | Durham | B110 Education | $1.7B | 3 |
| WAKE FOREST UNIVERSITY HEALTH SCIENCES | Winstonsalem | B50 Education | $1.6B | 18 |
| REX HOSPITAL INC | Raleigh | E22 Health Care | $1.6B | 24 |
| FORSYTH MEMORIAL HOSPITAL INC | Winston Salem | E220 Health Care | $1.4B | 13 |
| Research Triangle Institute | Research Triangle Park | U200 Science & Technology | $1.4B | 34 |
| CUMBERLAND COUNTY HOSPITAL SYSTEM INC | Fayetteville | E21 Health Care | $1.4B | 12 |
| NOVANT MEDICAL GROUP INC | Winston Salem | — | $1.3B | 11 |
| NORTH CAROLINA ELECTRIC MEMBERSHIP | Raleigh | Y22 Mutual & Membership Benefit | $1.3B | 11 |
| FIRSTHEALTH OF THE CAROLINAS INC | Pinehurst | E220 Health Care | $1.2B | 21 |
| Family Health International Inc | Durham | Q300 International, Foreign Affairs & National Security | $800M | 31 |
| GASTON MEMORIAL HOSPITAL INC | Gastonia | E220 Health Care | $790.9M | 14 |
| ATLANTIC COAST CONFERENCE | Charlotte | N400 Recreation & Sports | $706.6M | 9 |
| WAKE FOREST UNIVERSITY | Winstonsalem | B430 Education | $686.9M | 16 |
| East Carolina Health | Greenville | E20I Health Care | $596.8M | 27 |
| FOUNDATION FOR THE CAROLINAS | Charlotte | T310 Philanthropy, Voluntarism & Grantmaking Foundations | $538M | 14 |
| SANDHILLS CENTER FOR MENTAL HEALTH | West End | F300 Mental Health & Crisis Intervention | $532.9M | 11 |
| HIGH POINT REGIONAL HEALTH | High Point | E220 Health Care | $508.7M | 13 |
| HIGH POINT UNIVERSITY | High Point | B03 Education | $489.7M | 15 |
| THE LEON LEVINE FOUNDATION | Charlotte | — | $454.8M | 3 |
| GOTHIC HSP CORPORATION | Durham | E11 Health Care | $451.9M | 3 |
| Summit Foundation | Charlotte | — | $447.1M | 1 |
| NORTH CAROLINA INSURANCE UNDERWRITING | Raleigh | — | $446.8M | 8 |
| Elon University | Elon | B430 Education | $413M | 15 |
| ALAMANCE REGIONAL MEDICAL CENTER INC | Greensboro | E220 Health Care | $409.1M | 24 |
| University Health Systems of Eastern | Greenville | E110 Health Care | $401.3M | 28 |
| L C Industries Inc | Durham | P860 Human Services | $359.2M | 12 |
| Wayne Memorial Hospital Inc | Goldsboro | E220 Health Care | $353.3M | 12 |
| VIZO FINANCIAL CORPORATE CREDIT UNION | Greensboro | — | $342.7M | 10 |
| Vidant Medical Group LLC | Greenville | E122 Health Care | $336.6M | 13 |
| BLUE RIDGE HEALTHCARE HOSPITALS INC | Morganton | E220 Health Care | $306.1M | 14 |
| SOUTHEASTERN REGIONAL MEDICAL | Lumberton | E21 Health Care | $304.1M | 9 |
| ENERGYUNITED ELECTRIC MEMBERSHIP CO | Statesville | — | $301.1M | 23 |
| Scotland Memorial Hospital Inc | Laurinburg | E220 Health Care | $296.7M | 13 |
| FLETCHER HOSPITAL INC | Hendersonville | E220 Health Care | $289.7M | 24 |
| DOGWOOD HEALTH TRUST | Asheville | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $265.9M | 4 |
| NCInnovation Inc | Research Triangle Park | B19 Education | $259.1M | 3 |
| BRUNSWICK ELECTRIC MEMBERSHIP | Shallotte | — | $237.1M | 25 |
| FOOD BANK OF CENTRAL & EASTERN NC INC | Raleigh | K310 Food, Agriculture & Nutrition | $234M | 10 |
| CAMPBELL UNIVERSITY | Buies Creek | B430 Education | $231.3M | 15 |
| ASSOCIATION OF INTERNATIONAL CERTIFIED | Durham | S41 Community Improvement & Capacity Building | $223M | 12 |
