WAKE SPECIALTY PHYSICIANS, LLC


Address: 23 Sunnybrook Rd, Raleigh, NC 27610-1855
Phone: 9193507584

WAKE SPECIALTY PHYSICIANS, LLC (NPI# 1518378553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518378553
Entity Type Organization
Organization Name WAKE SPECIALTY PHYSICIANS, LLC
Other Organization Name WAKEMED PEDIATRIC ENDOCRINOLOGY
Practice Address 23 Sunnybrook Rd
Raleigh
NC 27610-1855
Mailing Address Po Box 602195
Charlotte
NC 28260-2195
Practice Telephone 9193507584
Practice Fax Number 9192310314
Mailing Telephone 9193500552
Enumeration Date 2014-05-13
Last Update Date 2016-09-12
Authorized Official Name MARIA JAYOUSSI (EXECUTIVE DIRECTOR FINANCE)
Authorized Official Telephone 9193506089
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0205X Pediatrics
Specialization: Pediatric Endocrinology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC 1942440375 05

Other Provider/Organization Names

Other Name Type Code
WakeMed Pediatric Endocrinology Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 23 SUNNYBROOK RD
City RALEIGH
State NC
Zip Code 27610-1855

Providers in the same location

NPI Name Taxonomy Address Enumeration
1386648756 James A Scovil Legal Medicine 23 Sunnybrook Rd, Ste 109, Raleigh, NC 27610-1855 2005-06-13
1861030371 Macon Louise Cornick Guidry Dietitian, Registered 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-12-16
1679129720 Amelia Willis Nurse Practitioner 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-08-14
1497307334 Wakemed Specialists Group LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-07-11
1336704766 Wakemed Specialists Group, LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-05-01
1265097695 Wakemed Specialists Group, LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-05-01
1245895697 Wakemed Specialists Group, LLC Counselor 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-05-01
1982269346 Wakemed Specialists Group, LLC Surgery 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-05-01
1962067314 Wakemed Specialists Group, LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-05-01
1659934511 Wake Specialty Physicians, LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-04-17
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2080P0205X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Endocrinology

Taxonomy Definition

A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.
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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265097695 Wakemed Specialists Group, LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-05-01
1457512493 Hillary E Lockemer Pediatrics 2610 New Bern Ave, Raleigh, NC 27610-1821 2008-06-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1073179867 Novant Medical Group, Inc. Pediatrics 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 2019-05-16
1124202114 Jennifer Rachel Law Pediatrics 3341 Mbrb Cb 7039, University of North Carolina, Chapel Hill, NC 27599-0001 2007-12-26
1245443126 Nina Jain Pediatrics Unc, Cb # 7039, 3341 Biomolecular (mbrb), Chapel Hill, NC 27599-0001 2007-05-08
1376696062 Cmc-northeast, Inc Pediatrics 16623 Birkdale Cmns Pkwy, Suite 110, Ne Pediatric Endo, Huntersville, NC 28078-5621 2007-01-18
1801825914 Lisa Houchin Pediatrics 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 2006-07-01
1437141611 Maria Janae Henwood-finley Pediatrics 2150 Herbert Ct, Ecu Pediatric Specialty Clinic, Greenville, NC 27834-3736 2005-08-16
1386164051 Novant Medical Group, Inc Pediatrics 201 Queens Rd, Charlotte, NC 28204-3217 2017-06-23
1902233380 The Charlotte-mecklenburg Hospital Authority Pediatrics 9625 Northcross Center Ct, Ste 102c, Huntersville, NC 28078-7348 2013-10-01
1912334335 The Charlotte-mecklenburg Hospital Authority Pediatrics 100 Medical Park Dr, Suite 310b, Concord, NC 28025-2948 2013-09-30
1700213113 The Charlotte-mecklenburg Hospital Authority Pediatrics 101 E Wt Harris Blvd, Bldg 3000 Ste 3301c, Charlotte, NC 28262-3485 2013-09-30
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Competitor

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City RALEIGH
Zip Code 27610

Improve Information

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Dataset Information

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.

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