WESTERN WAKE INTERNAL MEDICINE (NPI# 1811209901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811209901 |
| Entity Type | Organization |
| Organization Name | WESTERN WAKE INTERNAL MEDICINE |
| Practice Address |
907 Kildaire Farm Rd Cary NC 27511-3922 |
| Mailing Address |
5810 Nancy Ridge Dr 100 San Diego CA 92121-2834 |
| Practice Telephone | 9193196610 |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2010-07-06 |
| Authorized Official Name | KENNY HEINE (SR DIRECTOR OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 9801744 | NC | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760523260 | Western Wake Internal Medicine | Internal Medicine | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2007-02-09 |
| Street Address |
907 KILDAIRE FARM RD |
| City | CARY |
| State | NC |
| Zip Code | 27511-3922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336289065 | Raj Polavaram | Internal Medicine | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2007-02-08 |
| 1134687718 | Jacquelyn Nicole Barish | Nurse Practitioner | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2019-03-04 |
| 1164883401 | Wake Neuropathy P.a. | Chiropractor | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2016-03-15 |
| 1427487099 | Triangle Geriatric and Memory Clinic, Pllc | Internal Medicine | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2013-11-05 |
| 1225338304 | Piedmont Clinic of Chiropractic | Chiropractor | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2010-10-23 |
| 1366765968 | Sean Phillips | Chiropractor | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2010-03-10 |
| 1477717445 | Ramesh Babu Konduru | Internal Medicine | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2008-07-17 |
| 1760523260 | Western Wake Internal Medicine | Internal Medicine | 907 Kildaire Farm Rd, Cary, NC 27511-3922 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730792615 | Jill Manning West | Pharmacy | 118 Mackenan Dr., Suite 200, Cary, NC 27511 | 2020-08-28 |
| 1275145658 | Next Level Counseling, Pllc | Community/Behavioral Health | Tele-therapy Only, Cary, NC 27511 | 2020-08-18 |
| 1801429568 | Cheryl Perozek Reid | Physical Therapist | Brightstar Cary, 102 Commonwealth Court Unit K, Cary, NC 27511 | 2020-02-20 |
| 1912543075 | Courtney Hansen | Specialist/Technologist | 103 Fountain Brook Circle, D2, Cary, NC 27511 | 2019-11-25 |
| 1619438512 | Karlianna E.s Williams | Behavior Technician | 111 Mackenan, Cary, NC 27511 | 2019-03-25 |
| 1992272058 | Best Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 590 E Chatham Street, Ste 108, Cary, NC 27511 | 2018-10-26 |
| 1275015620 | Edward Michael Sleigh | Marriage & Family Therapist | 110 Iowa Ln, Ste 204, Cary, NC 27511 | 2018-09-02 |
| 1477044048 | Leonard Deleon | Pharmacist | 1230 Se Maynard Rd # 202, Cary, NC 27511 | 2018-05-19 |
| 1932699030 | Valerie Hunter Whidbee | Specialist | 139 E Chatham Street, Suite 105, Cary, NC 27511 | 2018-05-14 |
| 1588153878 | Ashley Horak Gyori | Speech-Language Pathologist | 905 Balmoral Dr, Cary, NC 27511 | 2018-05-02 |
| Find all providers in zip 27511 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659758316 | Avance Care Pa | Non-Pharmacy Dispensing Site | 115 Crescent Commons Dr, Suite 100, Cary, NC 27518-8102 | 2015-05-01 |
| 1669884094 | Carolina Partners In Mental | Non-Pharmacy Dispensing Site | 790 Se Cary Pkwy, Cary, NC 27511-5678 | 2014-05-20 |
| 1083959068 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 3420 Ten Ten Rd, 318, Cary, NC 27518-6100 | 2012-12-03 |
| 1073858122 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 100 Cornerstone Dr, Cary, NC 27519-8453 | 2012-11-30 |
| 1962720185 | Internal Medicine and Pediatrics Association | Non-Pharmacy Dispensing Site | 224 High House Rd, 100, Cary, NC 27513-4278 | 2010-05-12 |
| 1356575047 | Schmidt and Catchings Family Practice | Non-Pharmacy Dispensing Site | 600 New Waverly Pl, Suite 205, Cary, NC 27518-7404 | 2009-05-08 |
| 1255578415 | Cary Cardiology Associates | Non-Pharmacy Dispensing Site | 300 Keisler Dr, 200, Cary, NC 27518-7083 | 2009-01-09 |
| 1235279522 | Crescent Family Practice, P.a. | Non-Pharmacy Dispensing Site | 1000 Crescent Green Dr, Suite 202, Cary, NC 27511-8116 | 2007-02-07 |
| 1659411635 | Wellness Family Practice, P.a. | Non-Pharmacy Dispensing Site | 570 New Waverly Pl, 130, Cary, NC 27511-7405 | 2007-02-07 |
| 1154461127 | David Paul Adams, M.d., P.a. | Non-Pharmacy Dispensing Site | 218 Ashville Ave, Suite 20, Cary, NC 27511-6118 | 2007-02-07 |
| Find all providers in CARY | ||||
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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.