WAKEMED SPECIALISTS GROUP, LLC (NPI# 1063077436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063077436 |
| Entity Type | Organization |
| Organization Name | WAKEMED SPECIALISTS GROUP, LLC |
| Practice Address |
3000 New Bern Ave Raleigh NC 27610-1231 |
| Mailing Address |
2920 Highwoods Blvd Raleigh NC 27604-0010 |
| Practice Telephone | 9193507600 |
| Practice Fax Number | 9193508333 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |
| 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 | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WakeMed Heart & Vascular-Complex Arrhythmia | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326681164 | Wakemed Specialists Group, LLC | Durable Medical Equipment & Medical Supplies | 2930 Forestville Rd Ste 100, Raleigh, NC 27616-8774 | 2019-10-24 |
| 1407409543 | Wakemed Specialists Group, LLC | Pediatrics | 104 Medspring Dr, Clayton, NC 27520-9687 | 2019-07-18 |
| 1114582301 | Wakemed Specialists Group, LLC | Physical Therapist | 10010 Falls of Neuse Rd Ste 9, Raleigh, NC 27614-8495 | 2019-05-03 |
| 1376108522 | Wakemed Specialists Group, LLC | Orthopaedic Surgery | 8001 T W Alexander Dr Ste 224, Raleigh, NC 27617-4884 | 2019-05-03 |
| 1326684077 | Wakemed Specialists Group, LLC | Clinic/Center | 811 Us 70 Hwy W, Garner, NC 27529-2541 | 2019-11-18 |
| 1013552322 | Wakemed Specialists Group, LLC | Clinic/Center | 231 N Judd Pkwy Ne, Fuquay Varina, NC 27526-2694 | 2019-11-11 |
| 1588225759 | Wakemed Specialists Group, LLC | Preventive Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-06-27 |
| 1184289159 | Wakemed Specialists Group, LLC | Clinic/Center | 222 Ashville Ave Ste 10, Cary, NC 27518-6130 | 2019-05-06 |
| 1992360960 | Wakemed Specialists Group, LLC | Orthopaedic Surgery | 400 Us Highway 70 E, Ste 100, Garner, NC 27529-4850 | 2019-05-06 |
| 1720643927 | Wakemed Specialists Group, LLC | Otolaryngology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| Street Address |
3000 NEW BERN AVE |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-1231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972508661 | George Rayburn Cheely | Internal Medicine | 3000 New Bern Ave, Ste 1200, Raleigh, NC 27610-1231 | 2005-06-17 |
| 1811507700 | Erika Barbosa Richard | Registered Nurse | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-08-05 |
| 1790395846 | Dana Sroka Thomson | Physical Therapist | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-08-04 |
| 1477163756 | Sarah Anne Schwisow | Registered Nurse | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-08-03 |
| 1831708486 | Andrew Yoon | Physician Assistant | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-07-29 |
| 1770104622 | Sonya Zaghloul | Speech-Language Pathologist | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-05-01 |
| 1871121269 | Bethany Shaffer Flinchum | Clinic/Center | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-03-31 |
| 1326674789 | Thomas Mellette | Dietitian, Registered | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-03-18 |
| 1457986234 | Rose Meitzen | Nurse Practitioner | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-03-11 |
| 1932733847 | Olga Sushkevich | Dietitian, Registered | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-02-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
| 1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
| 1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
| 1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
| 1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
| 1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
| 1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| 1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
| 1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
| Find all providers in zip 27610 | ||||
| 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 |
|---|---|---|---|---|
| 1841713187 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 | 2017-07-19 |
| 1407919285 | Angelo Milazzo | Internal Medicine | 3713 Benson Dr Ste 202, Raleigh, NC 27609-7372 | 2006-12-19 |
| 1639253529 | James Wilson Peterson | Internal Medicine | 3320 Wake Forest Rd., Suite 200, Raleigh, NC 27609 | 2006-10-25 |
| 1821010067 | Walter Tan | Internal Medicine | 3000 New Bern Ave Ste 1100, Wpp - Structural Heart, Raleigh, NC 27610-1231 | 2006-07-24 |
| 1164485033 | Glenndale Moore | Internal Medicine | 2949 New Bern Ave, Suite 112-a, Raleigh, NC 27610-1248 | 2006-04-10 |
| 1881680098 | Joseph Anthony Guzzo | Internal Medicine | 4201 Lake Boone Trl, Suite 104, Raleigh, NC 27607-7512 | 2005-09-22 |
| 1972508661 | George Rayburn Cheely | Internal Medicine | 3000 New Bern Ave, Ste 1200, Raleigh, NC 27610-1231 | 2005-06-17 |
| 1245235506 | Sagir Ahmed | Internal Medicine | 3811 Ed Dr, Suite 130, Raleigh, NC 27612-2392 | 2005-06-14 |
| 1104480532 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-01 |
| 1720643174 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-01 |
| Find all providers in RALEIGH | ||||
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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.