DR. LYNNE SUSAN WIRTH (NPI# 1376512616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376512616 |
| Entity Type | Individual |
| Full Name | DR. LYNNE SUSAN WIRTH |
| Credential | M.D. |
| Practice Address |
2815 Cates Ave Raleigh NC 27695-0001 |
| Practice Telephone | 9195152563 |
| Practice Fax Number | 8889724151 |
| Mailing Telephone | 9195152563 |
| Mailing Fax Number | 8889724151 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2015-05-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
33770 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8988599 | 05 | |
| NC | BLUE CROSS BLUE SHIELD | 88599 | 01 |
| NC | AETNA | 7873164 | 01 |
| Street Address |
2815 CATES AVE |
| City | RALEIGH |
| State | NC |
| Zip Code | 27695-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609854728 | Catherine O'fallon Vinzani | Nurse Practitioner | 2815 Cates Ave, Box 7304, Raleigh, NC 27695-7304 | 2006-01-09 |
| 1194236588 | Suha Najjar | Nutritionist | 2815 Cates Ave, Raleigh, NC 27695-0001 | 2017-10-12 |
| 1801339320 | Noah Martinson | Social Worker | 2815 Cates Ave, Raleigh, NC 27695-0001 | 2016-12-01 |
| 1326403239 | Ashley Pinet | Dietitian, Registered | 2815 Cates Ave, Raleigh, NC 27695-0001 | 2015-12-18 |
| 1689951022 | North Carolina State University | Clinic/Center | 2815 Cates Ave, Cb 7304, Raleigh, NC 27695-0001 | 2011-11-14 |
| 1497987333 | Jacquetta Woods Melvin | Physician Assistant | 2815 Cates Ave, Campus Box 7304, Raleigh, NC 27695-7304 | 2009-08-11 |
| 1316182991 | Alison L Brim | Nurse Practitioner | 2815 Cates Ave, Campus Box 7304, Raleigh, NC 27695-7304 | 2008-12-10 |
| 1770745010 | Angel Bliss Johnson | Counselor | 2815 Cates Ave, Raleigh, NC 27695-0001 | 2008-06-27 |
| 1881712842 | North Carolina State University | Clinic/Center | 2815 Cates Ave, Cb 7304, Raleigh, NC 27695-7304 | 2007-03-27 |
| 1023146677 | Jason Troiano | Family Medicine | 2815 Cates Ave, Raleigh, NC 27695-7304 | 2007-03-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760911150 | Joy Bataille | Pharmacist | 2815 Cates Avenue, Raleigh, NC 27695 | 2017-06-08 |
| 1992334247 | Brianne Lawton | Specialist/Technologist | 1 Reynolds Coliseum, Raleigh, NC 27695-0001 | 2020-04-07 |
| 1164065827 | Whitney Beth Griffin | Psychologist | 2310 Stinson Drive Ncsu Dept of Psychology 640 Poe Hall, Raleigh, NC 27695-0001 | 2019-10-24 |
| 1023523552 | Soo Young Uhm | Dietitian, Registered | 2815 Cates Avenue Campus Box 7304, Raleigh, NC 27695-0001 | 2017-12-06 |
| 1578088316 | Andrew Bagley | Emergency Medicine | 2500 Warren Caroll Drive, Raleigh, NC 27695-0001 | 2017-08-12 |
| 1184149312 | Mianmian Sun | Pharmacist | 2815 Cates Ave Box 7304, Raleigh, NC 27695-0001 | 2017-08-09 |
| 1063952034 | Natalie Murr | Psychologist | 640 Poe Hl, 2310 Katharine Stinson Drive, Raleigh, NC 27695-0001 | 2017-02-24 |
| 1821413519 | Kristen Lyn Mostrom | Specialist/Technologist, Other | 2500 Warren Carroll Dr Box 8502, Raleigh, NC 27695-0001 | 2014-03-04 |
| 1457577975 | Sasha J Fradin | Psychologist | Ncsu Psychoeducational Clinic, Campus Box 7650, Raleigh, NC 27695-0001 | 2007-04-17 |
| 1699390021 | Scott Donald Ensell | Specialist/Technologist | 2500 Warren Carroll Dr, Raleigh, NC 27695-0001 | 2020-06-11 |
| Find all providers in zip 27695 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740622166 | Sunshine Pediatric and Adolescent Care | Pediatrics | 1631 Midtown Pl Ste 107, Raleigh, NC 27609-1300 | 2013-07-26 |
| 1134265721 | Daniel Elmer Brown | Pediatrics | 2412 Ridge Rd, Raleigh, NC 27612-4759 | 2007-01-30 |
| 1023077211 | Faith Pediatrics and Adolescent Medicine Inc. | Pediatrics | 3350 Six Forks Rd, Raleigh, NC 27609-7233 | 2006-03-17 |
| 1477524999 | Mary Beth Ogle Helton | Pediatrics | 2605 Blue Ridge Road, Suite 100, Raleigh, NC 27607-6678 | 2006-02-01 |
| 1265868806 | Easter Seals Ucp North Carolina & Virginia | Pediatrics | 314 Chapanoke Rd, Raleigh, NC 27603-3400 | 2013-09-14 |
| 1174888093 | Lyndsay Isil Weyers | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2012-07-06 |
| 1619286291 | Mari L. Emmet | Pediatrics | 2605 Blue Ridge Road, Suite 100, Raleigh, NC 27607-6475 | 2010-09-30 |
| 1386861268 | Maria Premilla Alexander | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2007-04-20 |
| 1346313475 | Peter Joseph Morris | Pediatrics | 220 Swinburne Rd, Raleigh, NC 27610-1834 | 2006-11-16 |
| 1962466631 | Jeffers Mann & Artman Pediatric & Adolesent Medicine Pa | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2006-04-12 |
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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.