WAKEMED FACULTY PRACTICE PLAN (NPI# 1588968184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588968184 |
| Entity Type | Organization |
| Organization Name | WAKEMED FACULTY PRACTICE PLAN |
| Other Organization Name | WAKEMED FACULTY PHYSICIANS-CAROLINA CARDIOLOGY |
| Practice Address |
3324 Six Forks Rd Raleigh NC 27609-7233 |
| Practice Telephone | 9197817772 |
| Practice Fax Number | 9197876331 |
| Mailing Telephone | 9197817772 |
| Mailing Fax Number | 9197876331 |
| Enumeration Date | 2010-12-23 |
| Last Update Date | 2010-12-23 |
| Authorized Official Name | DR. SUSAN TUCKER WEAVER (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 9193508228 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | WAKEMED FACULTY PRACTICE PLAN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WakeMed Faculty Physicians-Carolina Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013203819 | Wakemed Faculty Practice Plan | Hospitalist | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2011-06-21 |
| 1831485648 | Wakemed Faculty Practice Plan | Hospitalist | 1900 Kildaire Farm Rd, Cary, NC 27518-6616 | 2011-06-21 |
| 1568758365 | Wakemed Faculty Practice Plan | Internal Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2011-06-21 |
| 1336434067 | Wakemed Faculty Practice Plan | Internal Medicine | 1900 Kildaire Farm Rd, Cary, NC 27518-6616 | 2011-06-10 |
| 1598071524 | Wakemed Faculty Practice Plan | Internal Medicine | 3000 New Bern Ave, Suite 1200, Raleigh, NC 27610-1245 | 2010-08-27 |
| 1396791786 | Wakemed Faculty Practice Plan | Orthopaedic Surgery | 3024 New Bern Ave, Suite 300, Raleigh, NC 27610-1247 | 2006-05-26 |
| Street Address |
3324 SIX FORKS RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27609-7233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154320307 | John Mark Englehardt | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2005-07-19 |
| 1831500867 | Wake Specialty Physicians, LLC | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2014-05-13 |
| 1700104221 | Dwijesh Bhupendrakumar Patel | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609 | 2010-05-07 |
| 1396928966 | Jeffrey Robert Blackburn | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2007-12-06 |
| 1336130178 | Carolina Cardiology Consultants, Pa | Specialist | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2005-11-01 |
| 1437158508 | William Jonathan Parsons | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2005-07-20 |
| 1750380705 | John Simpson Kelley | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2005-07-20 |
| 1649279696 | Willard Lee Kennedy | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2005-07-20 |
| 1447259502 | Jack Watson Noneman | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2005-07-20 |
| 1497754659 | George Lee Hamrick Jr. | Internal Medicine | 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 2005-07-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184235582 | Choice Service Solutions LLC | In Home Supportive Care | 5300 Six Fox Rd Siite205, Raleigh, NC 27609 | 2020-08-11 |
| 1003426073 | Rosana Oba -rovira | Registered Nurse | 5300 Six Fox Road, Suite 205, Raleigh, NC 27609 | 2020-08-05 |
| 1821612706 | Helen Alexandra Bonner | Physical Medicine & Rehabilitation | Hey Clinic Pa, 3320 Wake Forest Road Ste 450, Raleigh, NC 27609 | 2020-06-05 |
| 1215423579 | Appiah Nana Larbi | Social Worker | Easter Seals Ucp 4000 Wake Forest Rd Ste 200, Raleigh, NC 27609 | 2018-07-10 |
| 1215423777 | Broadway Home Care LLC | In Home Supportive Care | 107 Windel Dr Ste 105, Raleigh, NC 27609 | 2018-07-09 |
| 1275027948 | Lacey Allene Cottingham | Social Worker | 312 W Millbrook Rd Ste 129, Raleigh, NC 27609 | 2018-06-18 |
| 1447748819 | Integrated Dermatology of North Raleigh, Pllc | Dermatology | 3809 Computer Dr Ste 200, Raleigh, NC 27609 | 2018-05-01 |
| 1902325418 | Naomi Christine Askew | Nurse Practitioner | 3400 Wake Forest Drive, Bldg 9, Bldg #9, 4th Floor, Raleigh, NC 27609 | 2017-09-15 |
| 1962929679 | Alexia Montague | Social Worker | 1306 Paddock Drive Suite E-100, Raleigh, NC 27609 | 2017-08-23 |
| 1730602236 | Chantel Washington-mbuthia | Counselor | 1100 Logger Ct. Ste C100, Heartfelt Alternative Inc, Raleigh, NC 27609 | 2017-07-18 |
| Find all providers in zip 27609 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841713187 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 | 2017-07-19 |
| 1407919285 | Angelo Milazzo | Internal Medicine | 3713 Benson Dr Ste 202, Raleigh, NC 27609-7372 | 2006-12-19 |
| 1639253529 | James Wilson Peterson | Internal Medicine | 3320 Wake Forest Rd., Suite 200, Raleigh, NC 27609 | 2006-10-25 |
| 1821010067 | Walter Tan | Internal Medicine | 3000 New Bern Ave Ste 1100, Wpp - Structural Heart, Raleigh, NC 27610-1231 | 2006-07-24 |
| 1164485033 | Glenndale Moore | Internal Medicine | 2949 New Bern Ave, Suite 112-a, Raleigh, NC 27610-1248 | 2006-04-10 |
| 1881680098 | Joseph Anthony Guzzo | Internal Medicine | 4201 Lake Boone Trl, Suite 104, Raleigh, NC 27607-7512 | 2005-09-22 |
| 1972508661 | George Rayburn Cheely | Internal Medicine | 3000 New Bern Ave, Ste 1200, Raleigh, NC 27610-1231 | 2005-06-17 |
| 1245235506 | Sagir Ahmed | Internal Medicine | 3811 Ed Dr, Suite 130, Raleigh, NC 27612-2392 | 2005-06-14 |
| 1104480532 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-01 |
| 1720643174 | Wakemed Specialists Group, LLC | Internal Medicine | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-05-01 |
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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.