WAKE SPECIALTY PHYSICIANS, LLC (NPI# 1447667209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447667209 |
| Entity Type | Organization |
| Organization Name | WAKE SPECIALTY PHYSICIANS, LLC |
| Other Organization Name | WAKEMED WAKE ORTHO |
| Practice Address |
3009 New Bern Ave Raleigh NC 27610-1214 |
| Mailing Address |
Po Box 602195 Charlotte NC 28260-2195 |
| Practice Telephone | 9192325020 |
| Mailing Telephone | 9193500552 |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2015-12-21 |
| Authorized Official Name | MARIA JAYOUSSI (EXECUTIVE DIRECTOR FINANCE) |
| Authorized Official Telephone | 9193506089 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | DME PTAN | 7108950005 | 01 |
| Other Name | Type Code |
|---|---|
| WakeMed Wake Ortho | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588216253 | Wake Specialty Physicians, LLC | Pediatrics | 204 Medspring Dr, Clayton, NC 27520-9293 | 2019-07-12 |
| 1346722865 | Wake Specialty Physicians, LLC | Orthopaedic Surgery | 120 Healthplex Way Ste 206, Apex, NC 27502-8403 | 2018-08-31 |
| 1811304678 | Wake Specialty Physicians, LLC | Durable Medical Equipment & Medical Supplies | 222 Ashville Ave Ste 10, Cary, NC 27518-6130 | 2014-07-14 |
| 1649686577 | Wake Specialty Physicians, LLC | Orthopaedic Surgery | 222 Ashville Ave Ste 20, Cary, NC 27518-6130 | 2014-07-11 |
| 1659934511 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-04-17 |
| 1922591049 | Wake Specialty Physicians, LLC | Surgery | 160 Macgregor Pines Dr, Cary, NC 27511-6036 | 2018-06-13 |
| 1861922775 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2017-06-13 |
| 1760861678 | Wake Specialty Physicians, LLC | Obstetrics & Gynecology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2015-05-26 |
| 1619374261 | Wake Specialty Physicians, LLC | Urology | 218 Ashville Ave, Cary, NC 27518-6118 | 2014-11-25 |
| 1740680222 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2014-09-03 |
| Street Address |
3009 NEW BERN AVE |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-1214 |
| 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 |
| 1417512690 | Wakemed Specialists Group LLC | Orthopaedic Surgery | 3009 New Bern Ave, Raleigh, NC 27610-1214 | 2019-05-03 |
| 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 |
| 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 | ||||
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| 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. |
| 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 |
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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.