WAKEMED SPECIALISTS GROUP LLC (NPI# 1255995643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255995643 |
| Entity Type | Organization |
| Organization Name | WAKEMED SPECIALISTS GROUP LLC |
| Other Organization Name | WAKEMED HOSPITALIST GROUP HOME |
| Practice Address |
2820 Kidd Rd Raleigh NC 27610-1842 |
| Mailing Address |
Po Box 603949 Charlotte NC 28260-3949 |
| Practice Telephone | 9193502800 |
| Practice Fax Number | 9193508147 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-08-13 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1255995643 | 05 |
| Other Name | Type Code |
|---|---|
| WakeMed Hospitalist Group Home | Doing Business As Name - Organization |
| WakeMed Hospitalist-Group Home | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811522089 | Wakemed Specialists Group LLC | Internal Medicine | 300 Keisler Dr, Cary, NC 27518-7083 | 2020-03-09 |
| 1497307334 | Wakemed Specialists Group LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-07-11 |
| 1790343366 | Wakemed Specialists Group LLC | Pediatrics | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-30 |
| 1225693419 | Wakemed Specialists Group LLC | Surgery | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1417512690 | Wakemed Specialists Group LLC | Orthopaedic Surgery | 3009 New Bern Ave, Raleigh, NC 27610-1214 | 2019-05-03 |
| 1205491487 | Wakemed Specialists Group LLC | Urology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| 1205491495 | Wakemed Specialists Group LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-03 |
| 1386209633 | Wakemed Specialists Group LLC | Clinic/Center | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2019-05-02 |
| 1073178398 | Wakemed Specialists Group LLC | Internal Medicine | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-02 |
| 1518521905 | Wakemed Specialists Group LLC | Obstetrics & Gynecology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2019-05-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | WakeMed Specialists Group LLC | 3000 New Bern Avenue, Raleigh, NC 27610 |
| Street Address |
2820 KIDD RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-1842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902083975 | Hilltop Home Inc. | Intermediate Care Facility, Mentally Retarded | 2820 Kidd Rd, Raleigh, NC 27610-1842 | 2008-01-22 |
| 1497204143 | Wake Specialty Physicians LLC | Family Medicine | 2820 Kidd Rd, Raleigh, NC 27610-1842 | 2016-09-22 |
| 1295088052 | Tashira Mone Hall | Licensed Practical Nurse | 2820 Kidd Rd, Raleigh, NC 27610-1842 | 2012-10-18 |
| 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 | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902083975 | Hilltop Home Inc. | Intermediate Care Facility, Mentally Retarded | 2820 Kidd Rd, Raleigh, NC 27610-1842 | 2008-01-22 |
| 1407978406 | Blessing Homes Inc. | Intermediate Care Facility, Mentally Retarded | 4229 Timberbrook Dr, Raleigh, NC 27616-9560 | 2007-04-03 |
| 1669592887 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 4409 Rockwood Dr, Raleigh, NC 27612-3542 | 2007-03-30 |
| 1992825129 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 8609 Stonegate Dr, Raleigh, NC 27615-2325 | 2007-03-30 |
| 1952421182 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 2533 Rolling Meadows Dr, Raleigh, NC 27603-9690 | 2007-03-30 |
| 1215057856 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 6208 Blanche Dr, Raleigh, NC 27607-5008 | 2007-03-29 |
| 1194845735 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 210 Dartmouth Rd, Raleigh, NC 27609-5846 | 2007-03-29 |
| 1174643787 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 3300 Huntleigh Dr, Raleigh, NC 27604-3312 | 2007-03-29 |
| 1174643712 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 5117 Forest Creek Rd, Raleigh, NC 27606-9419 | 2007-03-29 |
| 1114077856 | Tlc Operations, Inc. | Intermediate Care Facility, Mentally Retarded | 745 Chappell Dr, Raleigh, NC 27606-3215 | 2007-01-12 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on WAKEMED SPECIALISTS GROUP LLC.
| 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.