RALEIGH DURHAM MEDICAL GROUP PA (NPI# 1710331640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710331640 |
| Entity Type | Organization |
| Organization Name | RALEIGH DURHAM MEDICAL GROUP PA |
| Other Organization Name | FAMILY WELLNESS CLINIC RALEIGH |
| Practice Address |
8020 Creedmoor Rd Raleigh NC 27613-4363 |
| Mailing Address |
9276 Scranton Rd Suite 100 San Diego CA 92121-7701 |
| Practice Telephone | 9193222844 |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 0010-02907 | NC | Suppliers |
| Other Name | Type Code |
|---|---|
| Family Wellness Clinic Raleigh | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891704789 | Raleigh Durham Medical Group Pa | Family Medicine | 101 East Corbin St, Hillsborough, NC 27278 | 2006-08-07 |
| 1356387245 | Raleigh Durham Medical Group Pa | Obstetrics & Gynecology | 7019 Harps Mill Rd, Raleigh, NC 27615-3248 | 2006-06-21 |
| 1306899125 | Raleigh Durham Medical Group Pa | Family Medicine | 7124 Knightdale Blvd, Knightdale, NC 27545-9265 | 2006-05-19 |
| 1801848049 | Raleigh Durham Medical Group Pa | Family Medicine | 4905 Green Rd, Ste 100, Raleigh, NC 27616-2805 | 2006-05-16 |
| 1003868258 | Raleigh Durham Medical Group Pa | Family Medicine | 600 New Waverly Place, Ste 203, Cary, NC 27518 | 2006-05-16 |
| 1659322436 | Raleigh Durham Medical Group Pa | Family Medicine | 2076 Highway 42 W, Suite 230, Clayton, NC 27520-5303 | 2006-05-15 |
| 1649221342 | Raleigh Durham Medical Group Pa | Internal Medicine | 4003 N Roxboro St, Durham, NC 27704-2119 | 2006-05-15 |
| 1295784874 | Raleigh Durham Medical Group Pa | Obstetrics & Gynecology | 5420 Wade Park Blvd, Suite 106, Raleigh, NC 27607-4189 | 2006-05-09 |
| 1164865416 | Raleigh Durham Medical Group Pa | Non-Pharmacy Dispensing Site | 2076 Highway 42 West, Suite 230, Clayton, NC 27520 | 2013-04-16 |
| 1912243189 | Raleigh Durham Medical Group Pa | Non-Pharmacy Dispensing Site | 107 Weeks Dr, Roxboro, NC 27573-3933 | 2012-12-17 |
| Street Address |
8020 CREEDMOOR RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27613-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689624959 | Jennifer Greenfield | Chiropractor | 8020 Creedmoor Rd, Raleigh, NC 27613-4363 | 2006-05-10 |
| 1417557018 | Jason Ciapponi | Physician Assistant | 8020 Creedmoor Rd, Raleigh, NC 27613-4363 | 2020-11-01 |
| 1497251714 | Lea Mccallum Lott | Physician Assistant | 8020 Creedmoor Rd, Raleigh, NC 27613-4363 | 2018-04-04 |
| 1588959407 | Mary Katherine Williams | Physician Assistant | 8020 Creedmoor Rd, Raleigh, NC 27613-4363 | 2011-06-20 |
| 1912070392 | Greenfield Wellness Center | Chiropractor | 8020 Creedmoor Rd, Raleigh, NC 27613-4363 | 2006-11-16 |
| 1780631598 | Angela H Baylis | Chiropractor | 8020 Creedmoor Rd, Raleigh, NC 27613-4363 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588124358 | Arend Klooster Dds II, Pllc | Dentist | 3721 Lynn Rd. #120, Raleigh, NC 27613 | 2019-03-20 |
| 1205319647 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 9640 Leesville Rd, Raleigh, NC 27613 | 2018-09-12 |
| 1386137735 | Maitlyn Avery Betts | Specialist/Technologist | 8421 Two Courts Drive, Raleigh, NC 27613 | 2018-06-11 |
| 1811492382 | Malek & Knight Dds Pa-iil | Dentist | 9201 Leesville Rd Ste 101, Raleigh, NC 27613 | 2018-03-27 |
| 1285151860 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 13300 Stickland Rd, Raleigh, NC 27613 | 2017-08-24 |
| 1376072165 | Caitlin Ann Singleton | Dentist | 13220 Strickland Rd Ste 166, Raleigh, NC 27613 | 2017-06-06 |
| 1508246547 | Jonathan Kent Weisner | Dentist | 13271 Strickland Rd, Raleigh, NC 27613 | 2015-06-04 |
| 1245620806 | Kimberly Szwed | Nurse Practitioner | 6422 Rosny Road, Raleigh, NC 27613 | 2015-02-03 |
| 1174957831 | Laurin Ballowe Collier | Pharmacist | 9640 Leesville Road, Raleigh, NC 27613 | 2013-08-29 |
| 1952655144 | Phillip Colby Smith | Marriage & Family Therapist | 6921 Springcreek Cv Apt 22, Raleigh, NC 27613 | 2012-11-09 |
| Find all providers in zip 27613 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033589072 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 6010 Glenwood Ave, Raleigh, NC 27612-2602 | 2015-10-02 |
| 1952867095 | Associated Urologists of North Carolina Pa | Non-Pharmacy Dispensing Site | 3821 Ed Dr, Raleigh, NC 27612-8038 | 2019-02-13 |
| 1841600749 | Med One Medical Group | Non-Pharmacy Dispensing Site | 7019 Harps Mill Rd, Suite 200, Raleigh, NC 27615-3248 | 2014-04-30 |
| 1861810715 | Carolina Partners In Mental | Non-Pharmacy Dispensing Site | 1055 Dresser Ct, Raleigh, NC 27609-7323 | 2014-03-28 |
| 1346671732 | Avance Care Pa | Non-Pharmacy Dispensing Site | 7510 Ramble Way, Suite 107, Raleigh, NC 27616-4305 | 2013-12-10 |
| 1821338195 | Raleigh Durham Medical Group | Non-Pharmacy Dispensing Site | 701 Exposition Pl, Suite 208, Raleigh, NC 27615-3300 | 2013-02-25 |
| 1982949947 | Urgent Cares of America North Carolina Inc. | Non-Pharmacy Dispensing Site | 1311 E Millbrook Rd, Raleigh, NC 27609-5473 | 2012-12-03 |
| 1053656025 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 6500 Creedmoor Rd, 110, Raleigh, NC 27613-3697 | 2012-12-03 |
| 1942581947 | Avance Care P.a. | Non-Pharmacy Dispensing Site | 12341 Strickland Rd, 102, Raleigh, NC 27613 | 2011-09-02 |
| 1578889812 | Falls Pointe Medical Group | Non-Pharmacy Dispensing Site | 10010 Falls of Neuse Rd, 103, Raleigh, NC 27614-8494 | 2010-04-12 |
| Find all providers in RALEIGH | ||||
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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.