WAKEMED SPECIALISTS GROUP LLC (NPI# 1225693419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225693419 |
| Entity Type | Organization |
| Organization Name | WAKEMED SPECIALISTS GROUP LLC |
| Other Organization Name | WAKEMED GENERAL SURGERY |
| Practice Address |
3024 New Bern Ave Raleigh NC 27610-1247 |
| Mailing Address |
Po Box 603949 Charlotte NC 28260-3949 |
| Practice Telephone | 9193507331 |
| Practice Fax Number | 9198711228 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-08-21 |
| Authorized Official Name | MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 9193506089 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1225693419 | 05 |
| Other Name | Type Code |
|---|---|
| WakeMed General Surgery | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811522089 | Wakemed Specialists Group LLC | Internal Medicine | 300 Keisler Dr, Cary, NC 27518-7083 | 2020-03-09 |
| 1497307334 | Wakemed Specialists Group LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-07-11 |
| 1790343366 | Wakemed Specialists Group LLC | Pediatrics | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-30 |
| 1417512690 | Wakemed Specialists Group LLC | Orthopaedic Surgery | 3009 New Bern Ave, Raleigh, NC 27610-1214 | 2019-05-03 |
| 1205491487 | Wakemed Specialists Group LLC | Urology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1205491495 | Wakemed Specialists Group LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-03 |
| 1386209633 | Wakemed Specialists Group LLC | Clinic/Center | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2019-05-02 |
| 1073178398 | Wakemed Specialists Group LLC | Internal Medicine | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-02 |
| 1518521905 | Wakemed Specialists Group LLC | Obstetrics & Gynecology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-01 |
| 1255995643 | Wakemed Specialists Group LLC | Family Medicine | 2820 Kidd Rd, Raleigh, NC 27610-1842 | 2019-05-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | WakeMed Specialists Group LLC | 3000 New Bern Avenue, Raleigh, NC 27610 |
| Street Address |
3024 NEW BERN AVE |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-1247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664924 | Lynn M Rebello | Pediatrics | 3024 New Bern Ave, Raleigh, NC 27610 | 2005-07-28 |
| 1275158206 | Alejandro Ramirez Lopez | Physician Assistant | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2020-06-16 |
| 1588225759 | Wakemed Specialists Group, LLC | Preventive Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-06-27 |
| 1821659079 | Sharon Elizabeth Booth | Physician Assistant | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-06-27 |
| 1790343366 | Wakemed Specialists Group LLC | Pediatrics | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-30 |
| 1720643927 | Wakemed Specialists Group, LLC | Otolaryngology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1649835836 | Wakemed Specialists Group, LLC | Internal Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1205491487 | Wakemed Specialists Group LLC | Urology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1639734817 | Wakemed Specialists Group, LLC | Nutritionist | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1821653288 | Wakemed Specialists Group, LLC | Anesthesiology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
| 1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
| 1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
| 1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
| 1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
| 1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
| 1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| 1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
| 1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
| Find all providers in zip 27610 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356601066 | Stephanie Leigh Riggins | Surgery | 3024 New Bern Ave Fl 3, Raleigh, NC 27610 | 2012-05-29 |
| 1245515162 | New Hope Wellness and Total Bariatric Care | Surgery | 9910 Strickland Rd, Suite 100, Raleigh, NC 27615-2083 | 2011-10-12 |
| 1356524086 | Byron Keith Forgy | Surgery | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 | 2007-12-17 |
| 1295936714 | Matthew Alleman | Surgery | 3024 New Bern Ave Ste 304, Raleigh, NC 27610-1247 | 2007-05-31 |
| 1447340906 | Amber L Allen | Surgery | 6733 Falls of Neuse Rd, Raleigh, NC 27615-5305 | 2006-10-13 |
| 1376636548 | J Duncan Phillips | Surgery | 3024 New Bern Ave Suite 302, Raleigh, NC 27610 | 2006-10-02 |
| 1619991353 | Albert S. Chang | Surgery | 4420 Lake Boone Trl Ste 100, Raleigh, NC 27607-7505 | 2006-07-26 |
| 1801866108 | Uday S Kavde | Surgery | 3410 Six Forks Rd, Raleigh, NC 27609-7234 | 2006-01-26 |
| 1518945583 | Christopher Roy Watters | Surgery | 1212 Cedarhurst Drive, Suite 102, Raleigh, NC 27609 | 2006-01-09 |
| 1265419931 | William Tucker Cline | Surgery | 2800 Blue Ridge Blvd, Suite 201, Raleigh, NC 27607-6477 | 2005-12-23 |
| Find all providers in RALEIGH | ||||
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| 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.