WAKE SPECIALTY PHYSICIANS, LLC (NPI# 1760861678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760861678 |
| Entity Type | Organization |
| Organization Name | WAKE SPECIALTY PHYSICIANS, LLC |
| Other Organization Name | WAKEMED PHYSICIAN PRACTICES UROGYNECOLOGY |
| Practice Address |
10010 Falls of Neuse Rd Raleigh NC 27614-8494 |
| Mailing Address |
Po Box 602195 Charlotte NC 28260-2195 |
| Practice Telephone | 9193501380 |
| Practice Fax Number | 9195560124 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2018-03-14 |
| Authorized Official Name | MARIA JAYOUSSI (EXEC DIRECTOR, FINANCE) |
| Authorized Official Telephone | 9193506089 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 2088F0040X |
Urology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1942440375 | 05 |
| Other Name | Type Code |
|---|---|
| WakeMed Physician Practices Urogynecology | 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 |
| 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 |
10010 FALLS OF NEUSE RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27614-8494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972575934 | Inam Rashid | Family Medicine | 10010 Falls of Neuse Rd, Suite 103, Raleigh, NC 27614-8494 | 2006-02-03 |
| 1164059036 | Stephanie Schwarz Baker | Physical Therapist | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2020-03-23 |
| 1861030108 | Katherine Celeste Brewer | Occupational Therapist | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-12-17 |
| 1659936839 | Wakemed Specialists Group, LLC | Otolaryngology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-03 |
| 1073178398 | Wakemed Specialists Group LLC | Internal Medicine | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-02 |
| 1598320830 | Wakemed Specialists Group, LLC | Obstetrics & Gynecology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-02 |
| 1174188494 | Wakemed Specialists Group, LLC | Occupational Therapist | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-02 |
| 1518521905 | Wakemed Specialists Group LLC | Obstetrics & Gynecology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-01 |
| 1013571405 | Wakemed Specialists Group, LLC | Pediatrics | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8495 | 2019-05-01 |
| 1063076453 | Wakemed Specialists Group LLC | Obstetrics & Gynecology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215419379 | Patrick Orion Finn | Family Medicine | 10010 Falls of The Neuse Rd, Suite 11, Raleigh, NC 27614 | 2018-09-05 |
| 1538652557 | Amn Medical Group Pllc | General Practice | 13200 Falls of Neuse Rd Ste 113, Raleigh, NC 27614 | 2018-06-13 |
| 1497201727 | Kelsey Scheerer | Student in an Organized Health Care Education/Training Program | 11200 Governor Way, Raleigh, NC 27614 | 2016-08-28 |
| 1538521463 | Liane Rudd | Speech-Language Pathologist | 4700 Norbury Place, Raleigh, NC 27614 | 2016-03-21 |
| 1891088068 | Michelle Lynn Thompson | Pharmacist | 10930 Raven Ridge Road, Raleigh, NC 27614 | 2011-05-22 |
| 1821396185 | Bettye Jo Johnson | Physical Medicine & Rehabilitation | 11200 Governor Manly Way, Suite 305, Orhopaedic Specialists of North Carolina, Pa, Raleigh, NC 27614 | 2011-03-09 |
| 1982900650 | Blake Jennings Lamm | Pharmacist | 14460 New Falls of Neuse Rd, Suite 165, Raleigh, NC 27614 | 2011-01-28 |
| 1013223023 | Lauren S Lawler | Pharmacist | 11201 Durant Road, Raleigh, NC 27614 | 2010-08-27 |
| 1588985378 | Kashif Mazhar | General Acute Care Hospital | 10010 Falls of Neuse Road, Suite #12, Raleigh, NC 27614 | 2010-06-16 |
| 1922240100 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 14520 John Rex Blvd, Raleigh, NC 27614 | 2009-04-02 |
| Find all providers in zip 27614 | ||||
| Taxonomy Code | 2088F0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Female Pelvic Medicine and Reconstructive Surgery |
| A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
| Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437671443 | Arman Adam Kahokehr | Urology | Division of Urology Dumc 3146 Duke Clinics Cir Rm 1113, Durham, NC 27710-0001 | 2017-07-11 |
| 1821388034 | Marcella Gevonne Willis-gray | Urology | 3032 Old Clinic Bldg, Cb#7570, Chapel Hill, NC 27599-7570 | 2011-04-10 |
| 1437641164 | Novant Medical Group, Inc. | Urology | 1904 Jake Alexander Blvd W Ste 303, Salisbury, NC 28147-1177 | 2018-05-30 |
| 1033526181 | Moses Cone Affiliated Physicians, Inc. | Urology | 283 White Oak St, Asheboro, NC 27203-5431 | 2014-07-21 |
| 1407104466 | Carolinas Healthcare Associates, Inc. | Urology | 221 Memorial Dr, Jacksonville, NC 28546-6333 | 2012-08-24 |
| 1396918983 | Transylvania Physician Services, Inc. | Urology | 87 Medical Park Dr Ste A, Brevard, NC 28712-3210 | 2008-04-04 |
| 1235112897 | Vance F Merhoff | Urology | 911 W Henderson St, Ste 110, Salisbury, NC 28144-2736 | 2005-11-28 |
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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.