WAYNE HEALTH MEDICAL CLINIC, LLC (NPI# 1558630699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558630699 |
| Entity Type | Organization |
| Organization Name | WAYNE HEALTH MEDICAL CLINIC, LLC |
| Practice Address |
208 Cox Blvd Suite 102 Goldsboro NC 27534-9414 |
| Mailing Address |
Po Box 1717 Goldsboro NC 27533-1717 |
| Practice Telephone | 9195874081 |
| Practice Fax Number | 9195870775 |
| Mailing Telephone | 9195874081 |
| Mailing Fax Number | 9195870775 |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2015-12-10 |
| Authorized Official Name | 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 | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Street Address |
208 COX BLVD SUITE 102 |
| 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 |
| 1508230608 | Wayne Health Vascular and Vein Center LLC | Surgery | 208 Cox Blvd, Suite 201, Goldsboro, NC 27534-9414 | 2015-11-30 |
| 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 |
| 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 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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 |
|---|---|---|---|---|
| 1093753436 | Alfred E Okeke | Internal Medicine | 208 Cox Blvd Ste 102, Goldsboro, NC 27534-9414 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184030595 | Eric Lewis | Internal Medicine | 306 Parkridge Ave, Chapel Hill, NC 27517-8137 | 2014-07-07 |
| 1588077176 | Greensboro Endocrinology Pllc | Internal Medicine | 7 Corporate Center Ct Ste C, Greensboro, NC 27408-3839 | 2014-06-11 |
| 1043656770 | Thomas Cary Cameron | Internal Medicine | Division of Endocrinology & Metabolism, 8025 Burnett Womack Building, Chapel Hill, NC 27599-7170 | 2013-05-21 |
| 1033489216 | Tesfaye D Fanta Md Pllc | Internal Medicine | 910 W Harrison St, Reidsville, NC 27320-3324 | 2012-01-05 |
| 1548556749 | Leah Elizabeth Kang-oh | Internal Medicine | 755 Highland Oaks Dr Suite 201, Winston-salem, NC 27103 | 2011-06-26 |
| 1558656702 | Diabetes Management Solutions | Internal Medicine | 1100 Navaho Dr Ste 249, Raleigh, NC 27609-7364 | 2011-06-16 |
| 1174813570 | Chinenyenwa Usoh | Internal Medicine | 4610 Country Club Rd, Winston Salem, NC 27104-3520 | 2011-04-19 |
| 1366745259 | Carolinas Physicians Network Inc | Internal Medicine | 908 Donita Drive, Lincolnton, NC 28092-3643 | 2010-12-15 |
| 1982916342 | Vengamamba Polu | Internal Medicine | 701 Doctors Dr Ste D, Kinston, NC 28501-1584 | 2010-07-13 |
| 1073838132 | Alexandria Atuahene Opata | Internal Medicine | 16525 Holly Crest Ln Ste 230, Huntersville, NC 28078-4912 | 2010-04-01 |
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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.