WAKEMED SPECIALISTS GROUP LLC


Address: 3009 New Bern Ave, Raleigh, NC 27610-1214
Phone: 9192325020

WAKEMED SPECIALISTS GROUP LLC (NPI# 1417512690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417512690
Entity Type Organization
Organization Name WAKEMED SPECIALISTS GROUP LLC
Other Organization Name WAKEMED WAKE ORTHOPAEDICS
Practice Address 3009 New Bern Ave
Raleigh
NC 27610-1214
Mailing Address Po Box 603949
Charlotte
NC 28260-3949
Practice Telephone 9192325020
Practice Fax Number 9192325021
Mailing Telephone 9193500552
Mailing Fax Number 9193507687
Enumeration Date 2019-05-03
Last Update Date 2019-08-22
Authorized Official Name MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE)
Authorized Official Telephone 9193506089
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207XS0106X Orthopaedic Surgery
Specialization: Hand Surgery
Allopathic & Osteopathic Physicians
N 207XX0005X Orthopaedic Surgery
Specialization: Sports Medicine
Allopathic & Osteopathic Physicians
N 225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers
N 225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 207X00000X Orthopaedic Surgery Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC 1417512690 05

Other Provider/Organization Names

Other Name Type Code
WakeMed Wake Orthopaedics Other Name - Individual/Organization

Other Provider IDs and Locations

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
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
1255995643 Wakemed Specialists Group LLC Family Medicine 2820 Kidd Rd, Raleigh, NC 27610-1842 2019-05-01

Other Data Sources

Entity Type Entity Name Entity Address
North Carolina Corporations WakeMed Specialists Group LLC 3000 New Bern Avenue, Raleigh, NC 27610

Office Location

Street Address 3009 NEW BERN AVE
City RALEIGH
State NC
Zip Code 27610-1214

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720087133 Julian K Smith Physician Assistant 3009 New Bern Ave, Raleigh, NC 27610-1214 2005-07-18
1740895515 Joshua Samuel Turner Physician Assistant 3009 New Bern Ave, Raleigh, NC 27610-1214 2020-09-09
1750919734 Kyle Reynolds Physician Assistant 3009 New Bern Ave, Raleigh, NC 27610-1214 2020-03-27
1588229777 Wakemed Specialists Group, LLC Orthopaedic Surgery 3009 New Bern Ave, Raleigh, NC 27610-1214 2019-05-03
1376023234 Ronald Ross James Romanelli Physician Assistant 3009 New Bern Ave, Raleigh, NC 27610-1214 2018-08-20
1245741149 Taylor Winn Green Physician Assistant 3009 New Bern Ave, Raleigh, NC 27610-1214 2017-10-18
1912426636 Elizabeth Anne Mccool Physician Assistant 3009 New Bern Ave, Raleigh, NC 27610-1214 2017-09-13
1891172268 Summer Reavis Occupational Therapist 3009 New Bern Ave, Raleigh, NC 27610-1214 2015-05-05
1447667209 Wake Specialty Physicians, LLC Orthopaedic Surgery 3009 New Bern Ave, Raleigh, NC 27610-1214 2014-07-14
1306257241 Wake Specialty Physicians, LLC Orthopaedic Surgery 3009 New Bern Ave, Raleigh, NC 27610-1214 2014-05-14
Find all providers in the same location

Providers in the same zip code

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 Information

Taxonomy Code 207X00000X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery

Taxonomy Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376108522 Wakemed Specialists Group, LLC Orthopaedic Surgery 8001 T W Alexander Dr Ste 224, Raleigh, NC 27617-4884 2019-05-03
1669797353 Tyler Steven Watters Orthopaedic Surgery 3001 Edwards Mill Road, Suite 200, Raleigh, NC 27612-5243 2010-04-06
1881740405 Andre Grant Orthopaedic Surgery 3480 Wake Forest Road, Suite 204, Raleigh, NC 27609 2007-01-26
1629127634 Robert Esposito Orthopaedic Surgery 5620 Six Forks Rd Ste 104, Raleigh, NC 27609-8619 2007-01-09
1558313478 Raleigh Hand To Shoulder Center Pa Orthopaedic Surgery 3701 Wake Forest Rd Ste 3100, Raleigh, NC 27609-6832 2006-05-17
1477523876 Lloyd A Hey Orthopaedic Surgery 3320 Wake Forest Rd Ste 450, Raleigh, NC 27609 2006-01-26
1417927435 David Atwell Rendleman IIi Orthopaedic Surgery 3410 Executive Dr, Suite 103, Raleigh, NC 27609-7450 2006-01-23
1487647632 Alfonza Teel Orthopaedic Surgery 3100 Duraleigh Rd Ste 100, Raleigh, NC 27612-8105 2005-08-23
1467455832 Jon Kolkin Orthopaedic Surgery 3404 Wake Forest Rd, Ste 303, Raleigh, NC 27609-7341 2005-05-31
1003819434 James R Post Orthopaedic Surgery 3701 Wake Forest Rd, Suite 100, Raleigh, NC 27609-6832 2005-05-31
Find all providers in RALEIGH

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City RALEIGH
Zip Code 27610

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Dataset Information

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.

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