WAKE FOREST EMERGENCY PROVIDERS (NPI# 1396216735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396216735 |
| Entity Type | Organization |
| Organization Name | WAKE FOREST EMERGENCY PROVIDERS |
| Practice Address |
557 Brookdale Dr Statesville NC 28677-4100 |
| Mailing Address |
Medical Center Blvd Winston Salem NC 27157-0001 |
| Practice Telephone | 3367162255 |
| Mailing Telephone | 3367134944 |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2018-12-11 |
| Authorized Official Name | CHADWICK D MILLER (CHAIR OF EMERGENCY MEDICINE) |
| Authorized Official Telephone | 3367134944 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477104719 | Wake Forest Emergency Providers | Clinic/Center | 2005 Pisgah Church Rd, Greensboro, NC 27455-3309 | 2019-09-27 |
| Street Address |
557 BROOKDALE DR |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-4100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982606281 | Rocco Joseph Tritico | Specialist | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2005-06-01 |
| 1255807517 | Sarah E Pagano | Nurse Anesthetist, Certified Registered | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2018-10-15 |
| 1023503265 | Cecilia Kaechele | Nurse Practitioner | 557 Brookdale Dr, Statesville, NC 28677 | 2018-06-29 |
| 1063900512 | Amanda L Downs | Dietitian, Registered | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2018-04-30 |
| 1275049207 | Holly Townsend | Specialist/Technologist | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-12-28 |
| 1982115846 | Kayla Pierce | Registered Nurse | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-10-18 |
| 1245757665 | Wake Forest University Health Sciences | Clinic/Center | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-08-25 |
| 1609259183 | Nunta Campbell | Nurse Practitioner | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2015-07-02 |
| 1811381593 | Iredell Physician Network LLC | General Practice | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2015-03-20 |
| 1699197467 | Mary Elizabeth Weaver Corey | Physician Assistant | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2014-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
| 1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
| 1962069286 | Leap Child & Family Services LLC | Developmental Therapist | 119 North Tradd Street, Statesville, NC 28677 | 2019-05-22 |
| 1831604891 | Ingles Markets Inc | Pharmacy | 722 Sullivan Rd, Statesville, NC 28677 | 2017-12-12 |
| 1235663162 | Sandra Lorraine Scalese | Physical Therapy Assistant | 520 Valley Street, Brian Center Health and Rehabilitation, Statesville, NC 28677 | 2017-04-18 |
| 1437698891 | Sherry Blevins Hager | Pharmacist | 722 Sullivan Road, Statesville, NC 28677 | 2017-02-17 |
| 1063828507 | Susan Marie S Sheffield | Dentist | 518 Brookdale Drive, Statesville, NC 28677 | 2014-07-04 |
| 1659782449 | Easter Seals Ucp | Community/Behavioral Health | 913 Carolina Ave, Statesville, NC 28677 | 2014-05-14 |
| 1306268016 | Randall Scott Perry | Dentist | 1132 Davie Avenue, Statesville, NC 28677 | 2014-01-15 |
| 1215215876 | Silhouette Enterprises | Prosthetic/Orthotic Supplier | 909 Carolina Ave, Statesville, NC 28677 | 2011-08-01 |
| Find all providers in zip 28677 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245757665 | Wake Forest University Health Sciences | Clinic/Center | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851340 | Be Inc | Clinic/Center | 13 N Kaufman Stone Way, Candler, NC 28715-7721 | 2020-11-06 |
| 1801424171 | Recover Together, Inc. | Clinic/Center | 59 Haywood Office Park Ste 2, Waynesville, NC 28785-6998 | 2020-03-31 |
| 1891330056 | Veritas Collaborative Charlotte, LLC | Clinic/Center | 1900 Scott Ave Ste 101, Charlotte, NC 28203-6046 | 2019-11-12 |
| 1770135808 | American Family Care Fuquay Pllc | Clinic/Center | 1298 N Main St, Fuquay Varina, NC 27526-2615 | 2019-07-09 |
| 1508424029 | Shelly Renea Obasoluyi | Clinic/Center | 403 Atwell Dr, Fayetteville, NC 28314-0122 | 2019-05-30 |
| 1215593819 | Wilmington Health Pllc | Clinic/Center | 1811 Tiburon Dr, Wilmington, NC 28403-6254 | 2019-05-20 |
| 1003472804 | Loginclinics, Pllc | Clinic/Center | 1324 Reservoir View Ln, Wake Forest, NC 27587-1836 | 2019-05-16 |
| 1124586060 | Bethany Christian Services of Nc | Clinic/Center | 1110 Navaho Dr Ste 109, Raleigh, NC 27609-7352 | 2019-03-11 |
| 1548740038 | Hillsborough Community Urgent Care | Clinic/Center | 110 Boone Square St Ste 29a, Hillsborough, NC 27278-2665 | 2018-08-15 |
| 1679079537 | Carter Clinic, Pa | Clinic/Center | 260 1st Ave Nw Ste 215, Hickory, NC 28601-6161 | 2018-03-31 |
| Find all providers with the same taxonomy | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
Please comment or provide details below to improve the information on WAKE FOREST EMERGENCY PROVIDERS.
| 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.