WHA P.K.A. WILKERSON OBGYN (NPI# 1851706543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851706543 |
Entity Type | Organization |
Organization Name | WHA P.K.A. WILKERSON OBGYN |
Practice Address |
4414 Lake Boone Trl Suite 210 Raleigh NC 27607-7513 |
Practice Telephone | 9195711040 |
Practice Fax Number | 9197810247 |
Mailing Telephone | 9195711040 |
Mailing Fax Number | 9197810247 |
Enumeration Date | 2014-06-22 |
Last Update Date | 2014-06-22 |
Authorized Official Name | SUSAN P COKER (OFFICE MANAGER) |
Authorized Official Telephone | 9195711040 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 170100000X | Medical Genetics, Ph.D. Medical Genetics | 2014-00898 | NC | Other Service Providers |
Street Address |
4414 LAKE BOONE TRL SUITE 210 |
City | RALEIGH |
State | NC |
Zip Code | 27607-7513 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194729772 | Hugh Judd Grant Jr. | Obstetrics & Gynecology | 4414 Lake Boone Trl, Ste 210, Raleigh, NC 27607-7505 | 2005-06-10 |
1194175505 | Terence Makoid | Nurse Practitioner | 4414 Lake Boone Trl, Raleigh, NC 27607-7513 | 2016-06-16 |
1578925152 | Nastaran Gharkholonarehe | Pharmacist | 4414 Lake Boone Trl, Suite # 108, Raleigh, NC 27607-7513 | 2016-03-23 |
1689062176 | Kristin Lauer Allison | Nurse Practitioner | 4414 Lake Boone Trl, Suite 405, Raleigh, NC 27607-7513 | 2015-01-06 |
1457752305 | Centre Ob/gyn | Obstetrics & Gynecology | 4414 Lake Boone Trl, Suite 205, Raleigh, NC 27607-7513 | 2014-09-10 |
1154722072 | Raleigh Ob/gyn | Obstetrics & Gynecology | 4414 Lake Boone Trl, Suite 405, Raleigh, NC 27607-7513 | 2014-09-10 |
1427458629 | Kristie Reynolds Clontz | Nurse Practitioner | 4414 Lake Boone Trl, Suite 108, Raleigh, NC 27607-7513 | 2014-08-26 |
1699181917 | Jessica Hope Mullenix | Nurse Practitioner | 4414 Lake Boone Trl, Suite 402, Raleigh, NC 27607-7513 | 2014-07-08 |
1053660530 | Jenifer Rae Briscoe-brimmage | Obstetrics & Gynecology | 4414 Lake Boone Trl, Suite 405, Raleigh, NC 27607-7513 | 2012-08-30 |
1861777468 | Rex Hospital Inc | Internal Medicine | 4414 Lake Boone Trl, Suite 402, Raleigh, NC 27607-7513 | 2011-10-14 |
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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 | 170100000X |
Grouping | Other Service Providers |
Classification | Medical Genetics, Ph.D. Medical Genetics |
A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |
Notes: A general certificate was first issued by ABMS in 1982. ACGME Accredited Residency Program Requirements: None. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881799823 | Hiba Risheg | Medical Genetics, Ph.D. Medical Genetics | 201 Sage Rd Ste 300, Chapel Hill, NC 27514-6510 | 2006-09-14 |
1215044813 | Joe Mcknitt Alexander Jr. | Medical Genetics, Ph.D. Medical Genetics | 2911 Breezewood Ave Ste 201, Fayetteville, NC 28303 | 2006-08-23 |
1285740142 | Powells Medical Facility | Medical Genetics, Ph.D. Medical Genetics | 201 W Clinton St, Roseboro, NC 28382 | 2006-08-22 |
1013945732 | Siby Sebastian | Medical Genetics, Ph.D. Medical Genetics | 4425 Ben Franklin Blvd, Durham, NC 27704-2147 | 2006-06-29 |
1487622452 | Jack Tarleton | Medical Genetics, Ph.D. Medical Genetics | 267 Mcdowell St, Fullerton Genetics Laboratory, Asheville, NC 28803-2606 | 2006-03-08 |
1104890615 | Twanna Belinda Dixon-cherry | Medical Genetics, Ph.D. Medical Genetics | 118 W Martin Luther King Jr Dr, Washington, NC 27889-4906 | 2006-02-14 |
1578533360 | Megan M Harlan | Medical Genetics, Ph.D. Medical Genetics | 103 Mason Farm Road, Mbrb, Suite 4200, Campus Box 7264, Chapel Hill, NC 27599-0001 | 2006-01-24 |
1275510695 | Rapha Health System Inc | Medical Genetics, Ph.D. Medical Genetics | 1905 Skibo Rd, Suite 100, Fayetteville, NC 28314-1518 | 2005-12-28 |
1831194976 | Moon S Choi - Chung | Medical Genetics, Ph.D. Medical Genetics | 74 Eastgate Dr, Sylva, NC 28779-5171 | 2005-06-16 |
1811991342 | Myra Jane Hall | Medical Genetics, Ph.D. Medical Genetics | 210 Magnolia Square Court, Aberdeen, NC 28315-2226 | 2005-06-13 |
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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.