WAKEMED SPECIALISTS GROUP, LLC (NPI# 1356906705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356906705 |
| Entity Type | Organization |
| Organization Name | WAKEMED SPECIALISTS GROUP, LLC |
| Practice Address |
3024 New Bern Ave Raleigh NC 27610-1247 |
| Mailing Address |
2920 Highwoods Blvd Raleigh NC 27604-0010 |
| Practice Telephone | 9193505318 |
| Practice Fax Number | 9193507093 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |
| 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 |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WakeMed Gastroenterology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326681164 | Wakemed Specialists Group, LLC | Durable Medical Equipment & Medical Supplies | 2930 Forestville Rd Ste 100, Raleigh, NC 27616-8774 | 2019-10-24 |
| 1407409543 | Wakemed Specialists Group, LLC | Pediatrics | 104 Medspring Dr, Clayton, NC 27520-9687 | 2019-07-18 |
| 1114582301 | Wakemed Specialists Group, LLC | Physical Therapist | 10010 Falls of Neuse Rd Ste 9, Raleigh, NC 27614-8495 | 2019-05-03 |
| 1376108522 | Wakemed Specialists Group, LLC | Orthopaedic Surgery | 8001 T W Alexander Dr Ste 224, Raleigh, NC 27617-4884 | 2019-05-03 |
| 1326684077 | Wakemed Specialists Group, LLC | Clinic/Center | 811 Us 70 Hwy W, Garner, NC 27529-2541 | 2019-11-18 |
| 1013552322 | Wakemed Specialists Group, LLC | Clinic/Center | 231 N Judd Pkwy Ne, Fuquay Varina, NC 27526-2694 | 2019-11-11 |
| 1588225759 | Wakemed Specialists Group, LLC | Preventive Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-06-27 |
| 1184289159 | Wakemed Specialists Group, LLC | Clinic/Center | 222 Ashville Ave Ste 10, Cary, NC 27518-6130 | 2019-05-06 |
| 1992360960 | Wakemed Specialists Group, LLC | Orthopaedic Surgery | 400 Us Highway 70 E, Ste 100, Garner, NC 27529-4850 | 2019-05-06 |
| 1720643927 | Wakemed Specialists Group, LLC | Otolaryngology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 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 |
| 1225693419 | Wakemed Specialists Group LLC | Surgery | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 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 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730400268 | Amit Patel | Internal Medicine | 10207 Cerny St Ste 210, Raleigh, NC 27617-4887 | 2010-06-18 |
| 1811049307 | John V Yacono | Internal Medicine | 1011 Dresser Ct, Raleigh, NC 27609-7323 | 2007-01-17 |
| 1780778548 | Anant B Soni Md Pa | Internal Medicine | 3124 Blue Ridge Rd Ste 103, Raleigh, NC 27612-8041 | 2006-10-03 |
| 1750348769 | Sharif Riaz Chowdhury | Internal Medicine | 3024 New Bern Avenue, Suite 301, Raleigh, NC 27610 | 2006-04-26 |
| 1518968775 | Seth A Kaplan | Internal Medicine | 3100 Blue Ridge Rd, Suite 300, Raleigh, NC 27612-8036 | 2005-08-09 |
| 1073519880 | Ruth Mokeba-ekangaki | Internal Medicine | 2417 Atrium Dr, Suite 150, Raleigh, NC 27607-6673 | 2005-06-27 |
| 1588227839 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-04-22 |
| 1033679774 | Molly Whittaker Mcelroy | Internal Medicine | 3100 Blue Ridge Rd Ste 300, Raleigh, NC 27612-8002 | 2019-03-20 |
| 1487139929 | Raleigh D Eckert | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2018-10-01 |
| 1386195444 | Rex Hospital Inc | Internal Medicine | 2417 Atrium Drive, Suite 150, Raleigh, NC 27607-6673 | 2016-10-24 |
| 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.