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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 1942440375 | 05 |
Other Name | Type Code |
---|---|
WakeMed Pediatric Endocrinology | 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 |
23 SUNNYBROOK RD |
City | RALEIGH |
State | NC |
Zip Code | 27610-1855 |
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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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 | 2080P0205X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Endocrinology |
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. |
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 |
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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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.