WAKE SPECIALTY PHYSICIANS, LLC (NPI# 1588216253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588216253 |
| Entity Type | Organization |
| Organization Name | WAKE SPECIALTY PHYSICIANS, LLC |
| Other Organization Name | WAKEMED CHILDRENS PEDIATRICS CLAYTON |
| Practice Address |
204 Medspring Dr Clayton NC 27520-9293 |
| Mailing Address |
Po Box 602195 Charlotte NC 28260-2195 |
| Practice Telephone | 9192356505 |
| Practice Fax Number | 9193508147 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-12-12 |
| Authorized Official Name | MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 9193506089 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1588216253 | 05 |
| Other Name | Type Code |
|---|---|
| WakeMed Childrens Pediatrics Clayton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1447667209 | Wake Specialty Physicians, LLC | Orthopaedic Surgery | 3009 New Bern Ave, Raleigh, NC 27610-1214 | 2014-07-14 |
| Street Address |
204 MEDSPRING DR |
| City | CLAYTON |
| State | NC |
| Zip Code | 27520-9293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336750959 | Ebony Nichole Sanders | Driver | 312 Kilgo, Clayton, NC 27520 | 2020-08-17 |
| 1831701382 | Deawna Jackson | Social Worker | 205 Gracie Lane, Clayton, NC 27520 | 2020-08-17 |
| 1952947798 | Mac Partners LLC | Home Health | 10027 Hwy 70 Business, Suite B, Clayton, NC 27520 | 2019-11-26 |
| 1386291102 | Benjamin R Anderson | Physician Assistant | 2138 Nc 42, Clayton, NC 27520 | 2019-08-26 |
| 1396217923 | Lindsey R. Williams Dds, Pa | Dentist | 45 Shotwell Rd., Clayton, NC 27520 | 2018-12-20 |
| 1063987303 | Christopher James Lane | Physician Assistant | 2076 Nc 42 W, Suite 230, Clayton, NC 27520 | 2018-10-12 |
| 1245733971 | Cordelia O Emebo | Pharmacist | 11360 Old Us Hwy 70 West, Clayton, NC 27520 | 2018-03-08 |
| 1487166906 | Kendall Bonot Rodgers | Physician Assistant | 11491 Us 70 Bus Hwy W, Clayton, NC 27520 | 2017-10-25 |
| 1033620828 | Laura Nguyen | Physician Assistant | 2076 Nc-42, Suite 230, Clayton, NC 27520 | 2017-10-19 |
| 1467974394 | Liliana Galvan | Social Worker | 510 W Main St., Suit 100, Clayton, NC 27520 | 2017-07-12 |
| Find all providers in zip 27520 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - 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 |
|---|---|---|---|---|
| 1639603087 | Kidzcare Pediatrics, PC | Pediatrics | 189 Bo James St, Suite 1, Clayton, GA 30525-6066 | 2017-04-12 |
| 1427478684 | Dawn Elizabeth Scott | Pediatrics | 104 Medspring Dr Ste 100, Clayton, NC 27520-9687 | 2014-04-25 |
| 1124183710 | Ihab Abdel-aziz Abdel-khalek | Pediatrics | 11708 Hwy 70 West, Clayton, NC 27520 | 2006-12-26 |
| 1134195167 | Ryia M. Ross | Pediatrics | 112 S Hanley Rd, Suite 100, Clayton, MO 63105-3418 | 2006-02-28 |
| 1467443309 | Edwin F Ellis | Pediatrics | 1020 N Lawson Boulevard, Clayton, OK 74536-0219 | 2005-10-31 |
| 1093716482 | Kevin Francis Mcenaney | Pediatrics | 500 Gateway Dr, Clayton, NC 27520-2158 | 2005-08-09 |
| 1184274516 | Jessica Christine Kuhn Owens | Pediatrics | 500 Gateway Dr, Clayton, NC 27520-2158 | 2019-09-17 |
| 1770018186 | Kirabo Herbert | Pediatrics | 104 Medspring Dr Ste 100, Clayton, NC 27520-9687 | 2017-04-23 |
| 1811359680 | Christiana Akwari | Pediatrics | 104 Medspring Dr Ste 100, Clayton, NC 27520-9687 | 2016-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627146 | Kidzcare Pediatrics, PC | Pediatrics | Kidzcare Pediatrics, PC, 312 South Mccaskey Road, Williamston, NC 27892-2150 | 2020-10-21 |
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1992310627 | Carolinas Physicians Network Inc | Pediatrics | 1585 Forney Creek Pkwy Ste 2100, Denver, NC 28037-9520 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1871114470 | Kidzcare Pediatrics, PC | Pediatrics | 327 W College Ave, Shelby, NC 28152-8111 | 2020-05-05 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1689201568 | Mark Selna | Pediatrics | 13 Weybridge Pl, Chapel Hill, NC 27517-8938 | 2020-03-23 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| Find all providers with the same taxonomy | ||||
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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.