WAKE SPECIALTY PHYSICIANS, LLC (NPI# 1265848154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265848154 |
| Entity Type | Organization |
| Organization Name | WAKE SPECIALTY PHYSICIANS, LLC |
| Other Organization Name | WAKEMED URGENT CARE |
| Practice Address |
2406 Blue Ridge Rd Suite 190 Raleigh NC 27607-6678 |
| Mailing Address |
Po Box 602195 Charlotte NC 28260-2195 |
| Practice Telephone | 9197894322 |
| Practice Fax Number | 9197894533 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2015-12-31 |
| Authorized Official Name | MARIA JAYOUSSI (EXECUTIVE DIRECTOR FINANCE) |
| Authorized Official Telephone | 9193506089 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1013297365 | 05 | |
| NC | DME | 7108950009 | 01 |
| Other Name | Type Code |
|---|---|
| WAKEMED URGENT CARE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588216253 | Wake Specialty Physicians, LLC | Pediatrics | 204 Medspring Dr, Clayton, NC 27520-9293 | 2019-07-12 |
| 1346722865 | Wake Specialty Physicians, LLC | Orthopaedic Surgery | 120 Healthplex Way Ste 206, Apex, NC 27502-8403 | 2018-08-31 |
| 1811304678 | Wake Specialty Physicians, LLC | Durable Medical Equipment & Medical Supplies | 222 Ashville Ave Ste 10, Cary, NC 27518-6130 | 2014-07-14 |
| 1649686577 | Wake Specialty Physicians, LLC | Orthopaedic Surgery | 222 Ashville Ave Ste 20, Cary, NC 27518-6130 | 2014-07-11 |
| 1659934511 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-04-17 |
| 1922591049 | Wake Specialty Physicians, LLC | Surgery | 160 Macgregor Pines Dr, Cary, NC 27511-6036 | 2018-06-13 |
| 1861922775 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2017-06-13 |
| 1760861678 | Wake Specialty Physicians, LLC | Obstetrics & Gynecology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2015-05-26 |
| 1619374261 | Wake Specialty Physicians, LLC | Urology | 218 Ashville Ave, Cary, NC 27518-6118 | 2014-11-25 |
| 1740680222 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2014-09-03 |
| Street Address |
2406 BLUE RIDGE RD SUITE 190 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649260043 | Lori Moore Langdon | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2005-10-26 |
| 1386209633 | Wakemed Specialists Group LLC | Clinic/Center | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2019-05-02 |
| 1730656638 | Kushal Khimji | Pharmacist | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2018-10-29 |
| 1225446800 | Courtney Yerxa | Genetic Counselor, MS | 2406 Blue Ridge Rd, Suite 200, Raleigh, NC 27607-6678 | 2014-07-28 |
| 1801207543 | Melinda Lee Beavers | Pediatrics | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2014-05-15 |
| 1942625991 | Jamie Harding | Physician Assistant | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2014-02-27 |
| 1427493071 | Alison Lee Vurnakes | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2013-05-08 |
| 1154663482 | Alyssa Ann Jenkins | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2013-03-25 |
| 1225372246 | Duke University Affiliated Physicians, Inc | Obstetrics & Gynecology | 2406 Blue Ridge Rd, Suite 250, Raleigh, NC 27607-6678 | 2012-11-15 |
| 1174888093 | Lyndsay Isil Weyers | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2012-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445648 | Good Hope Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3601 Capital Blvd Ste 101, Raleigh, NC 27604-3397 | 2020-10-19 |
| 1518573468 | Joemax Healthcare Services LLC | Durable Medical Equipment & Medical Supplies | 3535 S Wilmington St Ste 208, Raleigh, NC 27603-3512 | 2020-09-16 |
| 1265059398 | Tiara Hyman | Durable Medical Equipment & Medical Supplies | 10040 Pineville Rd, Raleigh, NC 27617-6310 | 2020-07-06 |
| 1265055099 | Best American Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 1100 Navaho Dr Ste 121, Raleigh, NC 27609-7364 | 2020-05-27 |
| 1619516978 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 417 W Peace St Ste 100, Raleigh, NC 27603-5017 | 2020-01-03 |
| 1205471521 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 500 Oberlin Rd, Raleigh, NC 27605-1318 | 2019-11-11 |
| 1326681164 | Wakemed Specialists Group, LLC | Durable Medical Equipment & Medical Supplies | 2930 Forestville Rd Ste 100, Raleigh, NC 27616-8774 | 2019-10-24 |
| 1558820266 | Active Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 9104 Falls of Neuse Rd Ste 100, Raleigh, NC 27615-2494 | 2019-03-13 |
| 1912465311 | Shivag Diabetic Shoes and Orthotics LLC | Durable Medical Equipment & Medical Supplies | 3113 Brentwood Rd, Raleigh, NC 27604-2425 | 2019-03-05 |
| 1992273312 | Theramed Equipment and Supplies LLC | Durable Medical Equipment & Medical Supplies | 5720 Capital Blvd Ste G, Raleigh, NC 27616-2953 | 2018-11-03 |
| 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.