WAKE SPECIALTY PHYSICIANS LLC (NPI# 1912478496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912478496 |
| Entity Type | Organization |
| Organization Name | WAKE SPECIALTY PHYSICIANS LLC |
| Practice Address |
530 New Waverly Pl Cary NC 27518-7414 |
| Mailing Address |
Po Box 602195 Charlotte NC 28260-2195 |
| Practice Telephone | 9193502300 |
| Practice Fax Number | 9193507687 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2018-12-10 |
| Authorized Official Name | MARIA JAYOUSSI (EXEC. VP OF FINANCE) |
| Authorized Official Telephone | 9193500554 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1942440375 | 05 |
| Other Name | Type Code |
|---|---|
| Cary Breast Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225684004 | Wake Specialty Physicians LLC | Internal Medicine | 11640 Northpark Dr, Wake Forest, NC 27587-5741 | 2019-08-16 |
| 1841713187 | Wake Specialty Physicians LLC | Internal Medicine | 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 | 2017-07-19 |
| 1740702497 | Wake Specialty Physicians LLC | Internal Medicine | 101 Cotten Ln, Holly Springs, NC 27540-8415 | 2017-07-14 |
| 1407267347 | Wake Specialty Physicians LLC | Family Medicine | 3020 New Bern Ave, Raleigh, NC 27610-1215 | 2014-05-14 |
| 1225449168 | Wake Specialty Physicians LLC | Internal Medicine | 901 Old Knight Rd, Knightdale, NC 27545-9065 | 2014-05-14 |
| 1699186619 | Wake Specialty Physicians LLC | Family Medicine | 150 E Davie St, Raleigh, NC 27601-1806 | 2014-05-13 |
| 1346501673 | Wake Specialty Physicians LLC | Internal Medicine | 400 Us Highway 70 East, Garner, NC 27529-4049 | 2012-06-04 |
| 1427604149 | Wake Specialty Physicians LLC | Family Medicine | 7560 Carpenter Fire Station Rd, Cary, NC 27519-9637 | 2019-08-19 |
| 1871052597 | Wake Specialty Physicians LLC | Internal Medicine | 222 Ashville Ave, Cary, NC 27518-6130 | 2019-03-13 |
| 1649741950 | Wake Specialty Physicians LLC | Otolaryngology | 10010 Falls of Neuse Rd, Raleigh, NC 27614-8494 | 2018-12-13 |
| Street Address |
530 NEW WAVERLY PL |
| City | CARY |
| State | NC |
| Zip Code | 27518-7414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518966886 | Michael Malik | Surgery | 530 New Waverly Pl, Ste. 304, Cary, NC 27518-7414 | 2005-07-19 |
| 1194126268 | Private Diagnostic Clinic, Pllc | Internal Medicine | 530 New Waverly Pl, Suite 101, Cary, NC 27518-7414 | 2014-09-09 |
| 1467866152 | Triangle Wellness Pllc | Family Medicine | 530 New Waverly Pl, Suite 301, Cary, NC 27518-7414 | 2014-06-20 |
| 1598022394 | Garett Randall Franklin | Family Medicine | 530 New Waverly Pl, Suite 200, Cary, NC 27518-7414 | 2012-04-18 |
| 1912137365 | Sridevi Allu | Family Medicine | 530 New Waverly Pl, Suite 200, Cary, NC 27518-7414 | 2009-07-20 |
| 1104012343 | Raleigh Durham Medical Group Pa | Surgery | 530 New Waverly Pl, Ste. 304, Cary, NC 27518-7414 | 2007-09-21 |
| 1417086117 | Audrey C Avitabile | Nurse Practitioner | 530 New Waverly Pl, Suite 200, Cary, NC 27518-7414 | 2007-03-06 |
| 1457494254 | Rebecca Ann Boettcher | Nurse Practitioner | 530 New Waverly Pl, Suite 200, Cary, NC 27511-7414 | 2007-02-14 |
| 1912049669 | Sylvia Piqueras Shoffner | Internal Medicine | 530 New Waverly Pl, Suite 200, Cary, NC 27511-7414 | 2007-02-12 |
| 1063553436 | Susan Lawrence Crittenden | Internal Medicine | 530 New Waverly Pl, Suite 200, Cary, NC 27511-7414 | 2007-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932730801 | Fuller & Associates Iv, Pllc | Dentist | 3420 Ten-ten Road, Suite 310, Cary, NC 27518 | 2020-01-30 |
| 1649761602 | Uday N Reebye, Md. Dmd, Pa | Dentist | 431 Keisler Dr Ste 101, Cary, NC 27518 | 2018-05-25 |
| 1164912093 | Cary Dental Rejuvenation | Dentist | 155 Parkway Office Court, Suite 104, Cary, NC 27518 | 2018-05-16 |
| 1104337021 | Kaylah Mckinley Black | Nurse Practitioner | 530 New Waverly Pl Ste 301, Cary, NC 27518 | 2017-10-18 |
| 1013442961 | Amber Pinsky | Occupational Therapist | 5310 Woodfield Lake Road, Cary, NC 27518 | 2017-04-28 |
| 1750733564 | Maureen Lyons Reardon | Psychologist | 2500 Regency Parkway, Cary, NC 27518 | 2016-07-05 |
| 1730539651 | Anna Liakh | Dentist | 8204 Tryon Woods Dr, Cary, NC 27518 | 2016-06-21 |
| 1609236173 | Matthew John Myschisin II | Chiropractor | 4312 Farm Brook Dr, Cary, NC 27518 | 2016-02-26 |
| 1003299405 | Amanda Lee Morris | Social Worker | 531 Keisler Dr Ste 104, Cary, NC 27518 | 2015-07-02 |
| 1053791343 | Duke University Affiliated Physicians | Family Medicine | 530 Waverly Place, Suite 101, Cary, NC 27518 | 2015-06-02 |
| Find all providers in zip 27518 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 |
|---|---|---|---|---|
| 1639701980 | Orthopaedic Surgery Center of Panther Creek LLC | Surgery | 6715 Mccrimmon Pkwy Ste 100, Cary, NC 27519-1916 | 2020-02-05 |
| 1285927640 | The Band Center of The Carolinas, Pa | Surgery | 400 Ashville Ave Ste 200, Cary, NC 27518-6134 | 2011-05-18 |
| 1720041213 | David Zachary Zeiler | Surgery | 115 Crescent Commons Drive, Suite 200, Cary, NC 27518-8102 | 2006-04-07 |
| 1184694499 | David M Pilati | Surgery | 160 Macgregor Pines Dr, Suite 310, Cary, NC 27511 | 2006-01-26 |
| 1093796203 | Eric David Duberman | Surgery | 155 Parkway Office Ct, Suite 101, Cary, NC 27518-7426 | 2005-11-07 |
| 1518966886 | Michael Malik | Surgery | 530 New Waverly Pl, Ste. 304, Cary, NC 27518-7414 | 2005-07-19 |
| 1245236124 | Kenneth R Hauswald | Surgery | 1505 Sw Cary Pkwy, Suite 302, Cary, NC 27511-6219 | 2005-06-24 |
| 1922591049 | Wake Specialty Physicians, LLC | Surgery | 160 Macgregor Pines Dr, Cary, NC 27511-6036 | 2018-06-13 |
| 1194189837 | Emergeortho, Pa | Surgery | 160 Macgregor Pines Dr, Cary, NC 27511-6036 | 2016-04-08 |
| 1568873198 | Bariatric Specialists of North Carolina | Surgery | 160 Macgregor Pines Dr, Cary, NC 27511-6036 | 2014-05-16 |
| 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.