WAKE SPECIALTY PHYSICIANS, LLC


Address: 3000 New Bern Ave, Raleigh, NC 27610-1231
Phone: 9193507600

WAKE SPECIALTY PHYSICIANS, LLC (NPI# 1144634270) 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) 1144634270
Entity Type Organization
Organization Name WAKE SPECIALTY PHYSICIANS, LLC
Other Organization Name WAKEMED HEART & VASCULAR PHYSICIANS VASCULAR SURGERY
Practice Address 3000 New Bern Ave
Raleigh
NC 27610-1231
Mailing Address Po Box 602195
Charlotte
NC 28260-2195
Practice Telephone 9193507600
Practice Fax Number 9193508333
Mailing Telephone 9193500554
Enumeration Date 2014-06-17
Last Update Date 2016-09-12
Authorized Official Name MARIA JAYOUSSI (EXECUTIVE DIRECTOR)
Authorized Official Telephone 9193500554
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0129X Surgery
Specialization: Vascular Surgery
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC 1942440375 05

Other Provider/Organization Names

Other Name Type Code
WakeMed Heart & Vascular Physicians Vascular Surgery Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1588216253 Wake Specialty Physicians, LLC Pediatrics 204 Medspring Dr, Clayton, NC 27520-9293 2019-07-12
1346722865 Wake Specialty Physicians, LLC Orthopaedic Surgery 120 Healthplex Way Ste 206, Apex, NC 27502-8403 2018-08-31
1811304678 Wake Specialty Physicians, LLC Durable Medical Equipment & Medical Supplies 222 Ashville Ave Ste 10, Cary, NC 27518-6130 2014-07-14
1649686577 Wake Specialty Physicians, LLC Orthopaedic Surgery 222 Ashville Ave Ste 20, Cary, NC 27518-6130 2014-07-11
1659934511 Wake Specialty Physicians, LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2019-04-17
1922591049 Wake Specialty Physicians, LLC Surgery 160 Macgregor Pines Dr, Cary, NC 27511-6036 2018-06-13
1861922775 Wake Specialty Physicians, LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2017-06-13
1760861678 Wake Specialty Physicians, LLC Obstetrics & Gynecology 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 2015-05-26
1619374261 Wake Specialty Physicians, LLC Urology 218 Ashville Ave, Cary, NC 27518-6118 2014-11-25
1740680222 Wake Specialty Physicians, LLC Pediatrics 23 Sunnybrook Rd, Raleigh, NC 27610-1855 2014-09-03

Office Location

Street Address 3000 NEW BERN AVE
City RALEIGH
State NC
Zip Code 27610-1231

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104001742 Raleigh Vein & Laser Center Pa Surgery 10000 Falls of Neuse Rd., Suite 303, Raleigh, NC 27614 2008-01-02
1588602304 Richard David Edrington Surgery 3300 Executive Dr Ste 304, Raleigh, NC 27609-7492 2006-06-03
1033179122 Luan Tran Surgery 2245 Gateway Access Pt, Suite 315, Raleigh, NC 27607-3077 2006-03-24
1801450283 Wakemed Specialists Group, LLC Surgery 3713 Benson Dr, Raleigh, NC 27609-7371 2019-05-01
1811404999 North Carolina Vascular Specialists, Pa Surgery 3713 Benson Dr Ste 202, Raleigh, NC 27609-7372 2018-01-10
1275876393 Heather Waldrop Surgery 3300 Executive Dr Ste 304, Raleigh, NC 27609-7492 2013-03-27
1457621765 Rex Physicians LLC Surgery 2800 Blue Ridge Rd, Suite 300, Raleigh, NC 27607-6478 2012-01-03
1336443712 Rex Hospital Inc Surgery 4414 Lake Boone Trl, Suite 108, Raleigh, NC 27607-7513 2010-12-29
1053636894 Liliana Nanez Surgery 4414 Lake Boone Trl, Rex Vascular Specialists, Suite 108, Raleigh, NC 27607-7513 2010-04-05
1376733873 Jason K Kim Surgery 4414 Lake Boone Trl, Raleigh, NC 27607-7513 2007-07-31
Find all providers in RALEIGH

Competitor

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City RALEIGH
Zip Code 27610

Improve Information

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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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