WAKE SPECIALTY PHYSICIANS LLC (NPI# 1871052597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871052597 |
| Entity Type | Organization |
| Organization Name | WAKE SPECIALTY PHYSICIANS LLC |
| Other Organization Name | WAKEMED PRIMARY CARE KILDAIRE FARM ROAD |
| Practice Address |
222 Ashville Ave Cary NC 27518-6130 |
| Mailing Address |
Po Box 602195 Charlotte NC 28260-2195 |
| Practice Telephone | 9193506575 |
| Practice Fax Number | 9192356598 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-08-08 |
| 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 |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1871052597 | 05 |
| Other Name | Type Code |
|---|---|
| WAKEMED PRIMARY CARE KILDAIRE FARM ROAD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225684004 | Wake Specialty Physicians LLC | Internal Medicine | 11640 Northpark Dr, Wake Forest, NC 27587-5741 | 2019-08-16 |
| 1841713187 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 | 2017-07-19 |
| 1740702497 | Wake Specialty Physicians LLC | Internal Medicine | 101 Cotten Ln, Holly Springs, NC 27540-8415 | 2017-07-14 |
| 1407267347 | Wake Specialty Physicians LLC | Family Medicine | 3020 New Bern Ave, Raleigh, NC 27610-1215 | 2014-05-14 |
| 1225449168 | Wake Specialty Physicians LLC | Internal Medicine | 901 Old Knight Rd, Knightdale, NC 27545-9065 | 2014-05-14 |
| 1699186619 | Wake Specialty Physicians LLC | Family Medicine | 150 E Davie St, Raleigh, NC 27601-1806 | 2014-05-13 |
| 1346501673 | Wake Specialty Physicians LLC | Internal Medicine | 400 Us Highway 70 East, Garner, NC 27529-4049 | 2012-06-04 |
| 1427604149 | Wake Specialty Physicians LLC | Family Medicine | 7560 Carpenter Fire Station Rd, Cary, NC 27519-9637 | 2019-08-19 |
| 1649741950 | Wake Specialty Physicians LLC | Otolaryngology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2018-12-13 |
| 1912478496 | Wake Specialty Physicians LLC | Surgery | 530 New Waverly Pl, Cary, NC 27518-7414 | 2018-12-10 |
| Street Address |
222 ASHVILLE AVE |
| City | CARY |
| State | NC |
| Zip Code | 27518-6130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841249299 | Robin L Kuhls | Occupational Therapist | 222 Ashville Ave, Suite 20, Cary, NC 27518-6130 | 2006-05-10 |
| 1760840292 | Danielle Almond | Nurse Practitioner | 222 Ashville Ave, Suite 10, Cary, NC 27518-6130 | 2016-01-28 |
| 1598024028 | Margaret Thibodeau | Naturopath | 222 Ashville Ave, Suite 10, Cary, NC 27518-6130 | 2012-05-03 |
| 1316135908 | Donald Paul Zelna | Physical Therapist | 222 Ashville Ave, Suite 20, Cary, NC 27518-6130 | 2007-10-09 |
| 1609068329 | Youngin N. Gilmore | Family Medicine | 222 Ashville Ave, Suite 10, Cary, NC 27518-6130 | 2007-08-16 |
| 1003028069 | Laura A Southard | Physical Therapist | 222 Ashville Ave, Suite 20, Cary, NC 27518-6130 | 2007-05-04 |
| 1205943073 | Raleigh Orthopaedic Clinic Pa | Durable Medical Equipment & Medical Supplies | 222 Ashville Ave, Suite 20, Cary, NC 27511-6130 | 2006-08-25 |
| 1780606855 | Mazen Ezeldin Hamad | Family Medicine | 222 Ashville Ave, Suite10, Cary, NC 27518-6130 | 2006-07-24 |
| 1386675148 | Stefan T Maksymiw | Physical Therapist | 222 Ashville Ave, Suite 20, Cary, NC 27518-6130 | 2006-07-06 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482912 | Mideastern Primary Care Pllc | Family Medicine | 205 S Academy St Unit 4652, Cary, NC 27519-3538 | 2020-03-16 |
| 1679125439 | Teresa Lauren Britt | Family Medicine | 301 Ashville Ave Ste 111, Cary, NC 27518-6131 | 2019-07-11 |
| 1982131843 | Spectrum Family Medicine Pllc | Family Medicine | 519 Keisler Dr Ste 104, Cary, NC 27518-7098 | 2017-05-22 |
| 1053791343 | Duke University Affiliated Physicians | Family Medicine | 530 Waverly Place, Suite 101, Cary, NC 27518 | 2015-06-02 |
| 1326426792 | Christine Michelle Beyke | Family Medicine | 351 Wellesley Trade Ln Ste 100, Cary, NC 27519-5669 | 2015-05-18 |
| 1669868956 | Sydney Michelle Clark | Family Medicine | 540 New Waverly Pl Ste 200, Cary, NC 27518-7422 | 2015-04-13 |
| 1699197350 | Richard Ebken | Family Medicine | 7540 Mccrimmon Pkwy, Cary, NC 27519-1879 | 2014-01-15 |
| 1619228665 | Family Doctor Carync, P.l.l.c. | Family Medicine | 200 Keisler Dr Ste B, Cary, NC 27518-8801 | 2012-09-29 |
| 1538415377 | James Carver Hill | Family Medicine | 1316 Yubinaranda Cir, Cary, NC 27511-5629 | 2012-07-30 |
| 1437412871 | Ashley E Wofford Leong | Family Medicine | 1021 Darrington Dr, Generations Family Practice, Cary, NC 27513 | 2012-06-20 |
| Find all providers in CARY | ||||
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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.