WAKE SPECIALTY PHYSICIANS LLC (NPI# 1255851424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255851424 |
| Entity Type | Organization |
| Organization Name | WAKE SPECIALTY PHYSICIANS LLC |
| Other Organization Name | WAKEMED PRIMARY CARE FORESTVILLE CROSSING |
| Practice Address |
2930 Forestville Rd Raleigh NC 27616-8774 |
| Mailing Address |
Po Box 602195 Charlotte NC 28260-2195 |
| Practice Telephone | 9192356550 |
| Practice Fax Number | 9192356586 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2019-08-08 |
| 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1255851424 | 05 |
| Other Name | Type Code |
|---|---|
| WakeMed Physician Practices Primary Care Forestville | Doing Business As Name - Organization |
| WakeMed Physician Practices Primary Care Forestville Crossings | Doing Business As Name - Organization |
| WakeMed Primary Care Forestville Crossing | 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 |
2930 FORESTVILLE RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27616-8774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700873460 | Eugene Leung | Internal Medicine | 2930 Forestville Rd, Raleigh, NC 27616-8774 | 2005-09-28 |
| 1538511753 | Tatiana Hardy | Nurse Practitioner | 2930 Forestville Rd, Raleigh, NC 27616-8774 | 2016-07-12 |
| 1275953614 | William Panzo | Physician Assistant | 2930 Forestville Rd, Raleigh, NC 27616-8774 | 2014-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740768225 | Iam Healthcare, Pllc | Family Medicine | 5509 Cumberland Plain Dr, Raleigh, NC 27616 | 2018-08-06 |
| 1841791985 | George Solomon Edmond Sr. | Social Worker | 2700 Sumner Bldv Ste 142, Raleigh, NC 27616 | 2018-02-23 |
| 1366985194 | Kavita Joshi | Contractor | 3001 Spring Forest Road, Raleigh, NC 27616 | 2016-11-28 |
| 1447701701 | Nathaniel Byrams | Durable Medical Equipment & Medical Supplies | 5951 Poyner Village Parkway, Suite 101, Raleigh, NC 27616 | 2016-10-20 |
| 1760831424 | Courtney Lee Smith | Speech-Language Pathologist | 4804 Sinclair Dr, Raleigh, NC 27616 | 2016-06-03 |
| 1780060541 | Sharon Sims Smith | Pharmacist | 4901 Alenja Lane, Raleigh, NC 27616 | 2015-08-04 |
| 1427462035 | Cara Ellen Finn | Optometrist | 7500 Ramble Way Ste 101, Raleigh, NC 27616 | 2014-06-12 |
| 1609297209 | Vetted International, Ltd. | Ambulance | 6880 Perry Creek Road, Raleigh, NC 27616 | 2013-12-27 |
| 1437588324 | Lauren Primato | Counselor | 8645 Boysenberry Ln, Raleigh, NC 27616 | 2013-11-01 |
| 1275968729 | Rebecca Esliker | Counselor | 3200 Spring Forest Rd, Suite 214, Raleigh, NC 27616 | 2013-09-03 |
| Find all providers in zip 27616 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938894 | American Ecare Telehealth Pllc | Family Medicine | 5312 Pomfret Pt, Raleigh, NC 27612-3683 | 2020-06-27 |
| 1093339368 | Nc Telehealth, Pllc | Family Medicine | 1030 N Rogers Ln Ste 121, Raleigh, NC 27610-6083 | 2020-06-02 |
| 1427680917 | Peter Mcilwaine | Family Medicine | 2605 Blue Ridge Rd Ste 300, Raleigh, NC 27607-6475 | 2020-02-12 |
| 1104483387 | Rebecca Jeffries Cloer | Family Medicine | 8331 Bandford Way Ste 101, Raleigh, NC 27615-2765 | 2019-05-23 |
| 1154888154 | Wwc Medical Pllc | Family Medicine | 7800 Falls of Neuse Rd, #99511, Raleigh, NC 27615-9998 | 2019-02-26 |
| 1932683166 | Good Health Urgent & Primary Care Pllc | Family Medicine | 3716 National Dr Ste 208, Raleigh, NC 27612-4863 | 2018-09-24 |
| 1124501085 | Select Medical Services Pllc | Family Medicine | 10931 Raven Ridge Rd Ste 115, Raleigh, NC 27614-6499 | 2018-09-07 |
| 1215419379 | Patrick Orion Finn | Family Medicine | 10010 Falls of The Neuse Rd, Suite 11, Raleigh, NC 27614 | 2018-09-05 |
| 1740768225 | Iam Healthcare, Pllc | Family Medicine | 5509 Cumberland Plain Dr, Raleigh, NC 27616 | 2018-08-06 |
| 1265963938 | David James Mcmullen | Family Medicine | 3320 Executive Dr Ste 214, Raleigh, NC 27609-7489 | 2017-03-24 |
| 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.