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).
| 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 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1942440375 | 05 |
| Other Name | Type Code |
|---|---|
| WakeMed Heart & Vascular Physicians Structural Heart | Doing Business As Name - Organization |
| 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 |
| 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 | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| 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. |
| 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 |
| 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 |
| 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.