REX PHYSICIANS LLC (NPI# 1457621765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457621765 |
| Entity Type | Organization |
| Organization Name | REX PHYSICIANS LLC |
| Other Organization Name | REX COMPREHENSIVE VEIN CENTER |
| Practice Address |
2800 Blue Ridge Rd Suite 300 Raleigh NC 27607-6478 |
| Practice Telephone | 9197848346 |
| Practice Fax Number | 9197842708 |
| Mailing Telephone | 9197848346 |
| Mailing Fax Number | 9197842708 |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |
| Authorized Official Name | BERNADETTE M SPONG (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9197843245 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Rex Comprehensive Vein Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134464597 | Rex Physicians LLC | Neurological Surgery | 4207 Lake Boone Trl, Suite 220, Raleigh, NC 27607-6684 | 2012-12-11 |
| 1548510407 | Rex Physicians LLC | Audiologist | 790 Se Cary Pkwy, Suite 110, Cary, NC 27511-5678 | 2012-09-18 |
| 1134424062 | Rex Physicians LLC | Specialist | 910 Berkshire Rd, Smithfield, NC 27577-4751 | 2011-01-25 |
| 1598060808 | Rex Physicians LLC | Internal Medicine | 3000 New Bern Ave, Suite G-100, Raleigh, NC 27610-1231 | 2011-01-18 |
| 1063716447 | Rex Physicians LLC | Internal Medicine | 2800 Blue Ridge Rd, Suite 201, Raleigh, NC 27607-6478 | 2010-12-29 |
| 1831402874 | Rex Physicians LLC | Surgery | 2800 Blue Ridge Rd, Suite 503, Raleigh, NC 27607-6478 | 2010-07-20 |
| 1710213160 | Rex Physicians LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2800 Blue Ridge Road, Suite 403, Raleigh, NC 27607-6476 | 2009-10-20 |
| 1316273774 | Rex Physicians LLC | Internal Medicine | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2009-10-20 |
| 1881829018 | Rex Physicians LLC | Surgery | 2800 Blue Ridge Rd, Suite 503, Raleigh, NC 27607-6477 | 2009-05-18 |
| Street Address |
2800 BLUE RIDGE RD SUITE 300 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255335147 | Woodward Cannon | Surgery | 2800 Blue Ridge Rd, Ste 503, Raleigh, NC 27607-6477 | 2005-06-08 |
| 1134614050 | Shannon Dorothy Couture | Nurse Practitioner | 2800 Blue Ridge Rd, Raleigh, NC 27607 | 2018-06-23 |
| 1043703523 | Meredith Leigh Shillinglaw | Physician Assistant | 2800 Blue Ridge Rd, Raleigh, NC 27607 | 2018-06-11 |
| 1730629296 | Linh Thuc Nguyen | Nurse Practitioner | 2800 Blue Ridge Rd, Suite 400, Raleigh, NC 27607-6478 | 2017-03-03 |
| 1700320595 | Kathryn Star Salisbury | Nurse Practitioner | 2800 Blue Ridge Rd, Suite 400, Raleigh, NC 27607-6478 | 2016-12-13 |
| 1336598952 | Melissa Jennings Lunsford | Nurse Practitioner | 2800 Blue Ridge Rd, Suite 300, Raleigh, NC 27607-6478 | 2016-06-04 |
| 1821479213 | Jessica Wrench | Nurse Practitioner | 2800 Blue Ridge Rd, Raleigh, NC 27607-6478 | 2015-06-11 |
| 1255720801 | Karen Monger | Nurse Practitioner | 2800 Blue Ridge Rd, Suite 204, Raleigh, NC 27607-6478 | 2015-01-21 |
| 1811385776 | Keith Wesley Roberts | Physician Assistant | 2800 Blue Ridge Rd, Suite 400, Raleigh, NC 27607-6478 | 2014-12-30 |
| 1912338054 | Rex Hospital Inc | Surgery | 2800 Blue Ridge Rd, Suite 300, Raleigh, NC 27607-6478 | 2013-11-27 |
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| 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 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104001742 | Raleigh Vein & Laser Center Pa | Surgery | 10000 Falls of Neuse Rd., Suite 303, Raleigh, NC 27614 | 2008-01-02 |
| 1588602304 | Richard David Edrington | Surgery | 3300 Executive Dr Ste 304, Raleigh, NC 27609-7492 | 2006-06-03 |
| 1033179122 | Luan Tran | Surgery | 2245 Gateway Access Pt, Suite 315, Raleigh, NC 27607-3077 | 2006-03-24 |
| 1801450283 | Wakemed Specialists Group, LLC | Surgery | 3713 Benson Dr, Raleigh, NC 27609-7371 | 2019-05-01 |
| 1811404999 | North Carolina Vascular Specialists, Pa | Surgery | 3713 Benson Dr Ste 202, Raleigh, NC 27609-7372 | 2018-01-10 |
| 1144634270 | Wake Specialty Physicians, LLC | Surgery | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2014-06-17 |
| 1275876393 | Heather Waldrop | Surgery | 3300 Executive Dr Ste 304, Raleigh, NC 27609-7492 | 2013-03-27 |
| 1336443712 | Rex Hospital Inc | Surgery | 4414 Lake Boone Trl, Suite 108, Raleigh, NC 27607-7513 | 2010-12-29 |
| 1053636894 | Liliana Nanez | Surgery | 4414 Lake Boone Trl, Rex Vascular Specialists, Suite 108, Raleigh, NC 27607-7513 | 2010-04-05 |
| 1376733873 | Jason K Kim | Surgery | 4414 Lake Boone Trl, Raleigh, NC 27607-7513 | 2007-07-31 |
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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.