WAKEMED SPECIALISTS GROUP LLC (NPI# 1063076453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063076453 |
| Entity Type | Organization |
| Organization Name | WAKEMED SPECIALISTS GROUP LLC |
| Other Organization Name | WAKEMED OBSTETRICS & GYNECOLOGY |
| Practice Address |
10010 Falls of Neuse Rd Raleigh NC 27614-8494 |
| Mailing Address |
Po Box 603949 Charlotte NC 28260-3949 |
| Practice Telephone | 9193501380 |
| Practice Fax Number | 9195560124 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-08-13 |
| 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 | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1063076453 | 05 |
| Other Name | Type Code |
|---|---|
| WakeMed Obstetrics & Gynecology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811522089 | Wakemed Specialists Group LLC | Internal Medicine | 300 Keisler Dr, Cary, NC 27518-7083 | 2020-03-09 |
| 1497307334 | Wakemed Specialists Group LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-07-11 |
| 1790343366 | Wakemed Specialists Group LLC | Pediatrics | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-30 |
| 1225693419 | Wakemed Specialists Group LLC | Surgery | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1417512690 | Wakemed Specialists Group LLC | Orthopaedic Surgery | 3009 New Bern Ave, Raleigh, NC 27610-1214 | 2019-05-03 |
| 1205491487 | Wakemed Specialists Group LLC | Urology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1205491495 | Wakemed Specialists Group LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-03 |
| 1386209633 | Wakemed Specialists Group LLC | Clinic/Center | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2019-05-02 |
| 1073178398 | Wakemed Specialists Group LLC | Internal Medicine | 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | WakeMed Specialists Group LLC | 3000 New Bern Avenue, Raleigh, NC 27610 |
| 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 |
| 1649741950 | Wake Specialty Physicians LLC | Otolaryngology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2018-12-13 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396212080 | Fatima Sayyeda Ahmed | Obstetrics & Gynecology | 4904 Majestic Prince Ct, Raleigh, NC 27606-4269 | 2018-10-31 |
| 1457752511 | Carolina Gynecology Pa | Obstetrics & Gynecology | 700 Exposition Place, Suite 161, Raleigh, NC 27615-1563 | 2014-09-09 |
| 1134567787 | Brian Conrad Brimmage | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 405, Raleigh, NC 27607 | 2013-06-05 |
| 1629414164 | Aileen Jenna Beckham | Obstetrics & Gynecology | 3024 New Bern Ave Ste 309, Raleigh, NC 27610-1247 | 2013-05-10 |
| 1437436854 | Bassam Husam Rimawi | Obstetrics & Gynecology | 23 Sunnybrook Rd Ste 316, Raleigh, NC 27610-1874 | 2011-11-14 |
| 1891021853 | Private Diagnostic Clinic, Pllc | Obstetrics & Gynecology | 2406 Blue Ridge Road, Suite 200, Raleigh, NC 27607-6680 | 2009-10-27 |
| 1013159094 | Mary Carolyn Peavey | Obstetrics & Gynecology | 7920 Acc Blvd Ste 300, Raleigh, NC 27617-8744 | 2009-04-06 |
| 1821258518 | Kenneth Joseph Fortier | Obstetrics & Gynecology | 3701 Holly Ln, Unit 203, Raleigh, NC 27612-8051 | 2008-06-16 |
| 1093973075 | Patricia Ann Convery | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 205, Raleigh, NC 27607 | 2008-05-27 |
| 1063603124 | David Masao Kawasaki | Obstetrics & Gynecology | 9124 Palm Bay Cir, Raleigh, NC 27617-7776 | 2007-08-05 |
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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.