WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS (NPI# 1568455707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568455707 |
| Entity Type | Organization |
| Organization Name | WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS |
| Other Organization Name | MOCKSVILLE PEDIATRICS |
| Practice Address |
113 Marketplace Drive Mocksville NC 27028 |
| Practice Telephone | 3367538244 |
| Practice Fax Number | 3367538248 |
| Mailing Telephone | 3367538244 |
| Mailing Fax Number | 3367538248 |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2008-04-10 |
| Authorized Official Name | MR. LEWIS S THORP III (PRESIDENT CEO) |
| Authorized Official Telephone | 3367213900 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDICARE GROUP NUMBER | 2317728R | 01 |
| NC | 89015YH | 05 |
| Other Name | Type Code |
|---|---|
| Mocksville Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871780148 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 5391 Us Highway 158, Advance, NC 27006-6907 | 2007-10-01 |
| 1871797688 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 5175 Old Clemmons School Road, Clemmons, NC 27012 | 2007-06-14 |
| 1972596211 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 167 Moore Rd, King, NC 27021-8770 | 2005-08-23 |
| 1477546620 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 910 Worth St, Foothills Primary Care, Mount Airy, NC 27030-4458 | 2005-08-23 |
| 1417940636 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 509 Brookdale Dr, Young Family Practice, Statesville, NC 28677-4107 | 2005-08-23 |
| 1013900356 | Wake Forest University Baptist Medical Center Community Physicians | Internal Medicine | 1916 West Park Dr, North Wilkesboro, NC 28659-3563 | 2005-08-23 |
| 1316930654 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 7990 North Point Blvd, Winston Salem, NC 27106-3259 | 2005-08-23 |
| 1942489695 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 2801 Lyndhurst Ave, Winston Salem, NC 27103-4109 | 2007-10-30 |
| 1912111766 | Wake Forest University Baptist Medical Center Community Physicians | Internal Medicine | 1916 W Park Dr, North Wilkesboro, NC 28659-3563 | 2007-05-10 |
| 1588657605 | Wake Forest University Baptist Medical Center Community Physicians | Family Medicine | 304 Mountain View Rd, King, NC 27021-8768 | 2005-08-24 |
| Street Address |
113 MARKETPLACE DRIVE |
| City | MOCKSVILLE |
| State | NC |
| Zip Code | 27028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285270868 | Gaston Family Health Services, Inc. | Clinic/Center | 160 Martin Luther King Junior Rd, Mocksville, NC 27028 | 2019-11-19 |
| 1730649633 | Dawn Michelle Whitsel | Occupational Therapy Assistant | 498 Madison Rd., Mocksville, NC 27028 | 2019-03-25 |
| 1912476391 | Warren Hearing Solutions, LLC | Audiologist-Hearing Aid Fitter | 189 Gaither St, Mocksville, NC 27028 | 2018-11-15 |
| 1548711385 | Tyler Crane | Nurse Practitioner | 375 Hospital St Ste 200, Mocksville, NC 27028 | 2016-10-17 |
| 1679926042 | Nicholas Martyak | Physical Therapist | 161 Nikkis Way, Mocksville, NC 27028 | 2016-07-20 |
| 1386987790 | Elizabeth Hemmings | Speech-Language Pathologist | 498 Madison Road, Mocksville, NC 27028 | 2013-04-03 |
| 1932421427 | Davie Kidney Center of Wake Forest University | Clinic/Center | 190 Interstate Drive, Mocksville, NC 27028 | 2010-02-24 |
| 1912485517 | Davie Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 498 Madison Road, Mocksville, NC 27028 | 2018-08-06 |
| 1245747062 | Emma Beneke | Social Worker | 172 S Clement St, Mocksville, NC 27028 | 2018-01-02 |
| 1417345315 | Emily Draughn Collette | Nurse Practitioner | 485 Valley Rd, Mocksville, NC 27028 | 2014-12-30 |
| Find all providers in zip 27028 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235107020 | Evelyn Amy Suttle | Pediatrics | 161 E Lexington Rd, Mocksville, NC 27028-2635 | 2006-03-09 |
| 1841287638 | Clio Hamilton Austin | Pediatrics | 113 Market Place Dr, Mocksville, NC 27028-2084 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627146 | Kidzcare Pediatrics, PC | Pediatrics | Kidzcare Pediatrics, PC, 312 South Mccaskey Road, Williamston, NC 27892-2150 | 2020-10-21 |
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1992310627 | Carolinas Physicians Network Inc | Pediatrics | 1585 Forney Creek Pkwy Ste 2100, Denver, NC 28037-9520 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1871114470 | Kidzcare Pediatrics, PC | Pediatrics | 327 W College Ave, Shelby, NC 28152-8111 | 2020-05-05 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1689201568 | Mark Selna | Pediatrics | 13 Weybridge Pl, Chapel Hill, NC 27517-8938 | 2020-03-23 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| Find all providers with the same taxonomy | ||||
| City | MOCKSVILLE |
| Zip Code | 27028 |
Please comment or provide details below to improve the information on WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS.
| 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.