WAKE SPECIALTY PHYSICIANS LLC


Address: 3000 New Bern Ave, Raleigh, NC 27610-1231
Phone: 9192316333

WAKE SPECIALTY PHYSICIANS LLC (NPI# 1154713550) 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) 1154713550
Entity Type Organization
Organization Name WAKE SPECIALTY PHYSICIANS LLC
Other Organization Name WAKEMED HEART & VASCULAR PHYSICIANS STRUCTURAL HEART
Practice Address 3000 New Bern Ave
Raleigh
NC 27610-1231
Mailing Address Po Box 602195
Charlotte
NC 28260-2195
Practice Telephone 9192316333
Practice Fax Number 9192316334
Mailing Telephone 9193500552
Mailing Fax Number 9193507687
Enumeration Date 2015-02-23
Last Update Date 2015-09-24
Authorized Official Name MARIA JAYOUSSI (EXECUTIVE DIRECTOR FINANCE)
Authorized Official Telephone 9193506089
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
Allopathic & Osteopathic Physicians
N 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
Allopathic & Osteopathic Physicians
Y 207RC0001X Internal Medicine
Specialization: Clinical Cardiac Electrophysiology
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 Structural Heart Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1225684004 Wake Specialty Physicians LLC Internal Medicine 11640 Northpark Dr, Wake Forest, NC 27587-5741 2019-08-16
1841713187 Wake Specialty Physicians LLC Internal Medicine 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 2017-07-19
1740702497 Wake Specialty Physicians LLC Internal Medicine 101 Cotten Ln, Holly Springs, NC 27540-8415 2017-07-14
1407267347 Wake Specialty Physicians LLC Family Medicine 3020 New Bern Ave, Raleigh, NC 27610-1215 2014-05-14
1225449168 Wake Specialty Physicians LLC Internal Medicine 901 Old Knight Rd, Knightdale, NC 27545-9065 2014-05-14
1699186619 Wake Specialty Physicians LLC Family Medicine 150 E Davie St, Raleigh, NC 27601-1806 2014-05-13
1346501673 Wake Specialty Physicians LLC Internal Medicine 400 Us Highway 70 East, Garner, NC 27529-4049 2012-06-04
1427604149 Wake Specialty Physicians LLC Family Medicine 7560 Carpenter Fire Station Rd, Cary, NC 27519-9637 2019-08-19
1871052597 Wake Specialty Physicians LLC Internal Medicine 222 Ashville Ave, Cary, NC 27518-6130 2019-03-13
1649741950 Wake Specialty Physicians LLC Otolaryngology 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 2018-12-13

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
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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 207RC0001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Clinical Cardiac Electrophysiology

Taxonomy Definition

A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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
1154320307 John Mark Englehardt Internal Medicine 3324 Six Forks Rd, Raleigh, NC 27609-7233 2005-07-19
1063077436 Wakemed Specialists Group, LLC Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610-1231 2019-05-01
1780076000 Wake Specialty Physicians LLC Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610-1231 2015-02-24
1851782593 Wake Specialty Physicians LLC Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610-1231 2015-02-17
1972939643 Rex Hospital Inc Internal Medicine 2800 Blue Ridge Rd, Suite 400, Raleigh, NC 27607-6478 2013-09-25
1861690893 Geoffrey Faber Lewis Internal Medicine 2800 Blue Ridge Rd Ste 400, Raleigh, NC 27607-6477 2007-07-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1316120017 Anil K Gehi Internal Medicine 6025 Burnett Womack Bldg Cb 7075, 160 Dental Circle, Chapel Hill, NC 27599-7075 2007-12-17
1114076395 David W Frazier Internal Medicine 2340 Hemby Lane, Suite 100, Greenville, NC 27834 2007-01-09
1275557571 Sherry Saxonhouse Internal Medicine 307 Yadkin St, Albemarle, NC 28001-3441 2006-07-27
1720042013 Angela M Park Internal Medicine 1001 Newman Rd, New Bern, NC 28562-5253 2006-04-13
1588624217 Hemantkumar Patel Internal Medicine 800 Jefferson St, Ste 112, Whiteville, NC 28472-3710 2006-03-25
1922009935 Sanjay Prasher Internal Medicine 2301 Robeson St, Suite 301, Fayetteville, NC 28305-5640 2005-08-02
1801495387 Gillian Grace Winter Internal Medicine 1 Medical Center Blvd, Winston Salem, NC 27157-0001 2020-10-26
1033523709 Moses Cone Affiliated Physicians Internal Medicine 1126 N Church St, Suite 300, Greensboro, NC 27401-1000 2014-06-20
1417219163 Carolina Healthcare Associates, Inc. Internal Medicine 1515 Doctors Cir, Building C, Wilmington, NC 28401-7403 2012-06-08
1326306168 Matthew Justin Singleton Internal Medicine 1 Medical Center Blvd, Winston Salem, NC 27157-0001 2012-04-30
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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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