WAKEMED SPECIALISTS GROUP LLC (NPI# 1386209633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386209633 |
| Entity Type | Organization |
| Organization Name | WAKEMED SPECIALISTS GROUP LLC |
| Other Organization Name | WAKEMED URGENT CARE |
| Practice Address |
2406 Blue Ridge Rd Raleigh NC 27607-6678 |
| Mailing Address |
Po Box 603949 Charlotte NC 28260-3949 |
| Practice Telephone | 9197894322 |
| Practice Fax Number | 9197894533 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-08-15 |
| 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 |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1386209633 | 05 |
| Other Name | Type Code |
|---|---|
| WakeMed Urgent Care | 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 |
| 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 |
| 1255995643 | Wakemed Specialists Group LLC | Family Medicine | 2820 Kidd Rd, Raleigh, NC 27610-1842 | 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 |
2406 BLUE RIDGE RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649260043 | Lori Moore Langdon | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2005-10-26 |
| 1730656638 | Kushal Khimji | Pharmacist | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2018-10-29 |
| 1225446800 | Courtney Yerxa | Genetic Counselor, MS | 2406 Blue Ridge Rd, Suite 200, Raleigh, NC 27607-6678 | 2014-07-28 |
| 1265848154 | Wake Specialty Physicians, LLC | Durable Medical Equipment & Medical Supplies | 2406 Blue Ridge Rd, Suite 190, Raleigh, NC 27607-6678 | 2014-07-11 |
| 1801207543 | Melinda Lee Beavers | Pediatrics | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 | 2014-05-15 |
| 1942625991 | Jamie Harding | Physician Assistant | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2014-02-27 |
| 1427493071 | Alison Lee Vurnakes | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2013-05-08 |
| 1154663482 | Alyssa Ann Jenkins | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2013-03-25 |
| 1225372246 | Duke University Affiliated Physicians, Inc | Obstetrics & Gynecology | 2406 Blue Ridge Rd, Suite 250, Raleigh, NC 27607-6678 | 2012-11-15 |
| 1174888093 | Lyndsay Isil Weyers | Pediatrics | 2406 Blue Ridge Rd, Suite 100, Raleigh, NC 27607-6678 | 2012-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518102185 | Reliant Urgent Care of Brier Creek, P.a. | Clinic/Center | 7870 -110 Alexander Promenade Place, Raleigh, NC 27617-7350 | 2008-12-10 |
| 1184893075 | American Current Care of North Carolina PC | Clinic/Center | 4909 Green Road, Raleigh, NC 27616-2831 | 2008-02-25 |
| 1215127972 | Medfirst, Inc | Clinic/Center | 2731b Capital Blvd, Raleigh, NC 27604-1509 | 2007-07-30 |
| 1033234935 | Capital Urgent Care | Clinic/Center | 3509 Capital Blvd, Suite 101, Raleigh, NC 27604-3325 | 2007-03-20 |
| 1013572213 | Wakemed Specialists Group, LLC | Clinic/Center | 2406 Blue Ridge Rd Ste 190, Raleigh, NC 27607-6680 | 2019-05-03 |
| 1194051870 | Boss Urgent Care Pllc | Clinic/Center | 4450 Fayetteville Rd, Raleigh, NC 27603-3612 | 2009-10-30 |
| 1396071072 | Boss Urgent Care Pllc | Clinic/Center | 3396 Six Forks Rd, Raleigh, NC 27609-7233 | 2009-10-30 |
| 1710120795 | Duke University Affiliated Physicians, Inc. | Clinic/Center | 10211 Alm Street, Raleigh, NC 27617 | 2009-04-07 |
| 1265466460 | Matrix Occupational Health Inc | Clinic/Center | 4100 Wake Forest Rd, Raleigh, NC 27609-6227 | 2006-07-11 |
| 1952335184 | Matrix Occupational Health Inc | Clinic/Center | 6801 Pleasant Pines Dr, Suite 105, Raleigh, NC 27613-1939 | 2006-07-11 |
| 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.