WAKE SPINE AND PAIN SPECIALISTS, PC (NPI# 1811437338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811437338 |
| Entity Type | Organization |
| Organization Name | WAKE SPINE AND PAIN SPECIALISTS, PC |
| Practice Address |
400 Keisler Dr Cary NC 27518-7069 |
| Mailing Address |
3801 Wake Forest Rd Ste 210 Raleigh NC 27609-6864 |
| Practice Telephone | 9197877246 |
| Practice Fax Number | 9197877247 |
| Mailing Telephone | 9197877246 |
| Mailing Fax Number | 9197877247 |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2019-06-10 |
| Authorized Official Name | BERNADETTE MAUCERI (OFFICE MANAGER) |
| Authorized Official Telephone | 9197877246 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAKE SPINE AND PAIN SPECIALISTS, PC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3410 Executive Dr, Suite 209, Raleigh, NC 276097450 | 9197877246 | 9197877247 |
| 3801 Wake Forest Rd Ste 210, Raleigh, NC 276096864 | 9197877246 | 9197877247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467992982 | Wake Spine and Pain Specialists, PC | Anesthesiology | 10880 Durant Rd, Suite 324, Raleigh, NC 27614-6628 | 2017-03-02 |
| 1720528243 | Wake Spine and Pain Specialists, PC | Anesthesiology | 510 Timber Dr E Ste 105, Garner, NC 27529-4689 | 2017-03-02 |
| 1558801076 | Wake Spine and Pain Specialists, PC | Anesthesiology | 3801 Wake Forest Rd Ste 210, Raleigh, NC 27609-6864 | 2017-03-02 |
| Street Address |
400 KEISLER DR |
| City | CARY |
| State | NC |
| Zip Code | 27518-7069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366486920 | Jennifer B Simoni | Physician Assistant | 400 Keisler Dr, Cary, NC 27511-7069 | 2006-06-15 |
| 1073978854 | Amy Arruda | Physician Assistant | 400 Keisler Dr, Cary, NC 27518-7069 | 2015-12-22 |
| 1558734046 | Amy Gwynn | Physical Therapist | 400 Keisler Dr, Cary, NC 27518-7069 | 2015-11-05 |
| 1588008130 | G Lane Wagaman Ed.d. Pllc | Psychologist | 400 Keisler Dr, Cary, NC 27518-7069 | 2013-04-25 |
| 1790841492 | Neema Satish Patel | Nurse Practitioner | 400 Keisler Dr, Cary, NC 27511-7069 | 2006-12-28 |
| 1295829356 | Dan R Chartier | Psychologist | 400 Keisler Dr, Cary, NC 27511-7069 | 2006-10-03 |
| 1861401218 | William E Booth | Physical Therapist | 400 Keisler Dr, Cary, NC 27511-7069 | 2006-08-05 |
| 1538198213 | Christopher J Godbout | Physical Medicine & Rehabilitation | 400 Keisler Dr, Cary, NC 27511-7069 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932730801 | Fuller & Associates Iv, Pllc | Dentist | 3420 Ten-ten Road, Suite 310, Cary, NC 27518 | 2020-01-30 |
| 1649761602 | Uday N Reebye, Md. Dmd, Pa | Dentist | 431 Keisler Dr Ste 101, Cary, NC 27518 | 2018-05-25 |
| 1164912093 | Cary Dental Rejuvenation | Dentist | 155 Parkway Office Court, Suite 104, Cary, NC 27518 | 2018-05-16 |
| 1104337021 | Kaylah Mckinley Black | Nurse Practitioner | 530 New Waverly Pl Ste 301, Cary, NC 27518 | 2017-10-18 |
| 1013442961 | Amber Pinsky | Occupational Therapist | 5310 Woodfield Lake Road, Cary, NC 27518 | 2017-04-28 |
| 1750733564 | Maureen Lyons Reardon | Psychologist | 2500 Regency Parkway, Cary, NC 27518 | 2016-07-05 |
| 1730539651 | Anna Liakh | Dentist | 8204 Tryon Woods Dr, Cary, NC 27518 | 2016-06-21 |
| 1609236173 | Matthew John Myschisin II | Chiropractor | 4312 Farm Brook Dr, Cary, NC 27518 | 2016-02-26 |
| 1003299405 | Amanda Lee Morris | Social Worker | 531 Keisler Dr Ste 104, Cary, NC 27518 | 2015-07-02 |
| 1053791343 | Duke University Affiliated Physicians | Family Medicine | 530 Waverly Place, Suite 101, Cary, NC 27518 | 2015-06-02 |
| Find all providers in zip 27518 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346786266 | Interventional Pain Center, Pllc | Anesthesiology | 251 Keisler Dr, Suite 101, Cary, NC 27518-7091 | 2017-01-17 |
| 1568723096 | Cary Pain Center, PC | Anesthesiology | 251 Keisler Dr, Ste 101, Cary, NC 27518-7091 | 2012-05-31 |
| 1144586439 | Brian Hertzberg | Anesthesiology | 115 Kildaire Park Dr Ste 205, Cary, NC 27518-8127 | 2012-04-11 |
| 1568696748 | Wake Spine & Pain Specialists PC | Anesthesiology | 115 Kildaire Park Drive, Suite 205, Cary, NC 27518 | 2009-05-04 |
| 1528089588 | Chang J Feng | Anesthesiology | 251 Keisler Dr, Cary, NC 27518-7091 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174164057 | Regenerative Medical Institute,pllc | Anesthesiology | 1305 W. Wendover Ave., Ste A, Greensboro, NC 27408 | 2019-10-02 |
| 1598235830 | Mission Community Anesthesiology Specialists LLC | Anesthesiology | 89 Hospital Dr Ste C, Brevard, NC 28712-4838 | 2018-11-29 |
| 1508341736 | Bethany Medical Center | Anesthesiology | 190 Independence Ave Ste B, North Wilkesboro, NC 28659-4270 | 2018-10-03 |
| 1508347048 | Premier Pain Solutions Pllc | Anesthesiology | 5710 Oleander Dr Ste 201, Wilmington, NC 28403-4722 | 2018-08-23 |
| 1417434069 | Kyle Mason Fisher | Anesthesiology | Duke Univeristy Hospital Anesthesia Department, Durham, NC 27710-0001 | 2018-07-26 |
| 1306351432 | Carteret Surgical Associates P.a. | Anesthesiology | 2145 Country Club Rd Ste 400, Jacksonville, NC 28546-2400 | 2017-12-12 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1205372588 | Interventional Pain Center, Pllc | Anesthesiology | 517 B Hwy 210 N, Spring Lake, NC 28390 | 2017-01-11 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1356898720 | Ketamine Wellness Institute | Anesthesiology | 414 Cosgrove Ave, Chapel Hill, NC 27514-5271 | 2016-09-02 |
| 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.