WAYNE HEALTH VASCULAR AND VEIN CENTER LLC (NPI# 1508230608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508230608 |
| Entity Type | Organization |
| Organization Name | WAYNE HEALTH VASCULAR AND VEIN CENTER LLC |
| Practice Address |
208 Cox Blvd Suite 201 Goldsboro NC 27534-9414 |
| Practice Telephone | 9195873333 |
| Practice Fax Number | 9195873334 |
| Mailing Telephone | 9195873333 |
| Mailing Fax Number | 9195873334 |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |
| Authorized Official Name | MR. CLYDE LOUIS THOMAS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9195874081 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAYNE HEALTH PHYSICIANS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
200201214 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
208 COX BLVD SUITE 201 |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-9414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215950035 | Robert Joseph Albrecht Jr. | Surgery | 208 Cox Blvd, Ste 201, Goldsboro, NC 27534-9414 | 2006-07-25 |
| 1457912453 | Amanda Marie Pliler | Social Worker | 208 Cox Blvd, Goldsboro, NC 27534-9414 | 2019-06-21 |
| 1114385283 | Morgan Jackson | Nurse Practitioner | 208 Cox Blvd, Suite 201, Goldsboro, NC 27534-9414 | 2016-02-04 |
| 1134598212 | Heather Rae Holland | Nurse Practitioner | 208 Cox Blvd, Goldsboro, NC 27534-9414 | 2015-09-18 |
| 1053661066 | Wayne Health Physicians | Social Worker | 208 Cox Blvd, Suite 100, Goldsboro, NC 27534-9414 | 2012-09-17 |
| 1295092484 | Vontrelle Lynette Roundtree | Family Medicine | 208 Cox Blvd, Ste 102, Goldsboro, NC 27534-9414 | 2012-04-12 |
| 1558630699 | Wayne Health Medical Clinic, LLC | Internal Medicine | 208 Cox Blvd, Suite 102, Goldsboro, NC 27534-9414 | 2011-12-19 |
| 1326356940 | Tara Mclamb | Nurse Practitioner | 208 Cox Blvd, Ste 102, Goldsboro, NC 27534-9414 | 2010-09-16 |
| 1578883203 | Jennifer Scott Smith | Social Worker | 208 Cox Blvd, Suite 100, Goldsboro, NC 27534-9414 | 2010-06-04 |
| 1659571792 | Meredith Owen Godwin | Psychiatry & Neurology | 208 Cox Blvd, Ste 100, Goldsboro, NC 27534-9414 | 2007-07-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 |
|---|---|---|---|---|
| 1376885277 | Wayne Health Surgical Associates | Surgery | 2811 Mclamb Pl, Goldsboro, NC 27534-1647 | 2013-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831717693 | Mcleod Physician Associates II | Surgery | 690 Sunset Blvd N Ste 208, Sunset Beach, NC 28468-5332 | 2020-07-08 |
| 1053785220 | Novant Medical Group, Inc. | Surgery | 1420 Us Highway North 52, Suite B, Albermarle, NC 28001 | 2015-11-25 |
| 1962756148 | Vein Essentials, PC | Surgery | 580 Mccarthy Blvd, New Bern, NC 28562-5217 | 2012-11-09 |
| 1548544984 | Statesville Hma Medical Group, LLC | Surgery | 1703 Davie Ave, Statesville, NC 28677-3521 | 2011-10-04 |
| 1639310642 | Vcp Raleigh, LLC | Surgery | 6905 Knightdale Blvd Ste 105, Knightdale, NC 27545-6504 | 2009-03-20 |
| 1104001742 | Raleigh Vein & Laser Center Pa | Surgery | 10000 Falls of Neuse Rd., Suite 303, Raleigh, NC 27614 | 2008-01-02 |
| 1265613624 | Pinehurst Surgical Clinic Pa | Surgery | 1705b Berwick Dr, Laurinburg, NC 28352-5523 | 2007-11-14 |
| 1871791301 | Kathryn Lorann Davis | Surgery | 2001 Vail Ave Ste 320, Charlotte, NC 28207-1222 | 2007-07-05 |
| 1578656773 | Coastal Carolina Surgical Associates, P.a. | Surgery | 1411 Physicians Drive, Wilmington, NC 28401-7338 | 2006-10-02 |
| 1750499851 | Michael David Lininger | Surgery | 149 Macarthur St, Asheboro, NC 27203-5410 | 2006-08-28 |
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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.