WAKE SPECIALTY PHYSICIANS


Address: 555 Medical Park Pl, Suite 110, Clayton, NC 27520-2174
Phone: 9198618939

WAKE SPECIALTY PHYSICIANS (NPI# 1942554019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1942554019
Entity Type Organization
Organization Name WAKE SPECIALTY PHYSICIANS
Other Organization Name WSP-RALEIGH CARDIOLOGY
Practice Address 555 Medical Park Pl
Suite 110
Clayton
NC 27520-2174
Mailing Address 3000 New Bern Ave
Suite 1200
Raleigh
NC 27610-1231
Practice Telephone 9198618939
Mailing Telephone 9192316132
Enumeration Date 2012-10-29
Last Update Date 2012-10-29
Authorized Official Name DR. SUSAN TUCKER WEAVER (EXECUTIVE VICE PRESIDENT)
Authorized Official Telephone 9193508228
Authorized Official Credential MD
Is Organization Subpart Y
Parent Organization Name WAKE SPECIALTY PHYSICIANS

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
Allopathic & Osteopathic Physicians
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
WSP-RALEIGH CARDIOLOGY Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1346852407 Wake Specialty Physicians Internal Medicine 2001 S Main St Ste 200, Wake Forest, NC 27587-1652 2020-08-20
1225417132 Wake Specialty Physicians Nutritionist 3024 New Bern Ave, Raleigh, NC 27610-1247 2015-05-26
1598011173 Wake Specialty Physicians Internal Medicine 100 Ridge View Dr, Suite 105, Cary, NC 27511-5589 2012-08-01
1396000188 Wake Specialty Physicians Internal Medicine 6102 Grace Park Dr, Morrisville, NC 27560-6003 2012-07-09
1548539380 Wake Specialty Physicians Durable Medical Equipment & Medical Supplies 212 Ashville Ave, Suite 30, Cary, NC 27518-6669 2011-12-23
1215206057 Wake Specialty Physicians Durable Medical Equipment & Medical Supplies 3024 New Bern Ave, Raleigh, NC 27610-1247 2011-12-23

Office Location

Street Address 555 MEDICAL PARK PL
SUITE 110
City CLAYTON
State NC
Zip Code 27520-2174

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639151780 Thomas Stylski Podiatrist 555 Medical Park Pl, Suite 205, Clayton, NC 27520-2174 2005-11-15
1093091431 Laboratory Corporation of America Holdings Clinical Medical Laboratory 555 Medical Park Pl, Ste 201, Clayton, NC 27520-2174 2011-10-31
1275835621 Cancer Centers of North Carolina PC Internal Medicine 555 Medical Park Pl, Suite 207, Clayton, NC 27520-2174 2010-11-17
1306023916 Ellen P Bauman Social Worker 555 Medical Park Pl, Clayton, NC 27520-2174 2008-01-25
1790722395 Christopher M Barry Physician Assistant 555 Medical Park Pl, Suite 208, Clayton, NC 27520-2174 2006-06-01

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013955574 Cardiology Associates of Johnston, Pllc Internal Medicine 11618 Us Highway 70 W, Clayton, NC 27520-2253 2006-06-04
1235565946 Clayton Medical and Vascular Center Pllc Internal Medicine 101 Winding Wood Dr, Clayton, NC 27520-4493 2013-09-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1124657663 Cardiosleep Diagnostics Internal Medicine 1862 Old Fort Rd, Greenville, NC 27834-9373 2020-04-06
1619467529 Clerio Francisco De Azevedo Filho Internal Medicine 10 Medicine Circle - Duke Medical Pavilion Room 1e50, Durham, NC 27710-0001 2018-05-16
1700385846 The Presbyterian Hospital Internal Medicine 1918 Randolph Rd Ste 820, Charlotte, NC 28207-1119 2018-02-05
1841713187 Wake Specialty Physicians LLC Internal Medicine 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 2017-07-19
1225563463 Benjamin Mcginty Chilcutt Internal Medicine 300 Meadowmont Village Cir Ste 104, Chapel Hill, NC 27517-7518 2017-04-25
1437517182 Regional Physicians LLC Internal Medicine 103 W Center St, Lexington, NC 27292 2016-02-09
1982069928 Four Jewels Healthways Internal Medicine 320 Lillington Ave Ste 201, Charlotte, NC 28204-3189 2015-12-17
1932505294 Donald Frederick Fortin Internal Medicine 14001 Weston Pkwy, Suite 101, Cary, NC 27513-2255 2014-11-14
1538564232 Forsyth Memorial Hospital, Inc Internal Medicine 694 Riverside Drive, Mt. Airy, NC 27030-3117 2014-10-24
1710382411 Forsyth Memorial Hospital, Inc Internal Medicine 7114 Villiage Medical Circle, Clemmons, NC 27012 2014-10-24
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Competitor

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City CLAYTON
Zip Code 27520

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Dataset Information

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.

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