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).
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 |
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 Name | Type Code |
---|---|
WSP-RALEIGH CARDIOLOGY | Doing Business As Name - Organization |
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 |
Street Address |
555 MEDICAL PARK PL SUITE 110 |
City | CLAYTON |
State | NC |
Zip Code | 27520-2174 |
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 |
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 |
Find all providers in zip 27520 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
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. |
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 |
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 |
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.