WENDELL CLAVONN JOHN (NPI# 1942288790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942288790 |
| Entity Type | Individual |
| Full Name | WENDELL CLAVONN JOHN |
| Credential | RN, MSN, FNP-C |
| Practice Address |
2001 S Main St Wake Forest NC 27587-1612 |
| Practice Telephone | 9195623155 |
| Practice Fax Number | 9195627401 |
| Mailing Telephone | 9195623155 |
| Mailing Fax Number | 9195627401 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2018-12-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201749 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC NURSING LICENSE # | 170923 | 01 |
| NC | NC NURSE PRACTITIONER # | 201749 | 01 |
| NC | DEA CERTIFICATE # | MJ0970435 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3050 Duraleigh Rd Ste 111, Raleigh, NC 276125451 | 9842156990 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629118328 | Wendell E. John | Adult Companion | 2330 Ne Siskiyou St, Portland, OR 97212-2471 | 2007-02-08 |
| Street Address |
2001 S MAIN ST |
| City | WAKE FOREST |
| State | NC |
| Zip Code | 27587-1612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790222891 | Kayla Diane Lerro | Physician Assistant | 2001 S Main St, #200, Wake Forest, NC 27587-1649 | 2017-01-26 |
| 1649727306 | Caitlin Meredith Wetzel | Physician Assistant | 2001 S Main St, #200, Wake Forest, NC 27587-1649 | 2016-09-09 |
| 1851636799 | The Compounding Shoppe &farmacy,llc | Pharmacy | 2001 S Main St, Wake Forest, NC 27587-1649 | 2012-12-04 |
| 1972848950 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 2001 S Main St, 200, Wake Forest, NC 27587-1649 | 2012-12-03 |
| 1366745044 | Urgent Cares of America North Carolina Inc | Family Medicine | 2001 S Main St, Suite 200, Wake Forest, NC 27587-1649 | 2010-12-17 |
| 1285883207 | Healthfirst Pharmacy of Wake Forest,llc | Pharmacy | 2001 S Main St, Wake Forest, NC 27587-1612 | 2008-09-15 |
| 1447409859 | Lynn Holt | Pharmacist | 2001 S Main St, Wake Forest, NC 27587-1612 | 2008-09-10 |
| 1942377668 | Health First Pharmacy of Wake Forest LLC | Durable Medical Equipment & Medical Supplies | 2001 S Main St, Wake Forest, NC 27587-1649 | 2006-11-29 |
| 1609949288 | Jason Anthony Williams | General Practice | 2001 S Main St, Suite 200, Wake Forest, NC 27587-1612 | 2006-11-15 |
| 1932210119 | Anne Davison Baden | Psychologist | 2001 S Main St, Suite 200, Wake Forest, NC 27587-1649 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831713080 | Catherine Restrepo | Speech-Language Pathologist | 900 S Franklin St, Ste 201, Wake Forest, NC 27587 | 2020-06-03 |
| 1942760277 | Samantha Fae Pugh | Occupational Therapist | 200 Dr. Calvin Jones Hwy, Suite 200, Wake Forest, NC 27587 | 2019-03-22 |
| 1851863609 | The Counseling Collective | Counselor | 1764 Heritage Center Drive, 204, Wake Forest, NC 27587 | 2018-12-18 |
| 1891270856 | Halston Hoke | Speech-Language Pathologist | 620 Dr. Calvin Jones Hwy Ste 200, Wake Forest, NC 27587 | 2018-09-26 |
| 1710465620 | Amy K Tarnowski | Physical Therapist | The Lodge At Wake Forest, 1151 South Main Street, Wake Forest, NC 27587 | 2018-08-02 |
| 1518452341 | Language and Literacy 365, Pllc | Speech-Language Pathologist | 956 Templeridge Rd, Wake Forest, NC 27587 | 2018-06-25 |
| 1467951723 | Justin Mitchell | Physical Therapist | 843 Durham Rd Suite 110, Wake Forest, NC 27587 | 2018-02-01 |
| 1124544499 | Carolina Concussion & Physical Medicine, Pllc | Chiropractor | 120 Capcom Aveune, Suite 104, Wake Forest, NC 27587 | 2017-08-18 |
| 1902293889 | Katherine Armine Lorch | Student in an Organized Health Care Education/Training Program | 3000 Rogers Road Ste 210, Wake Forest, NC 27587 | 2015-04-18 |
| 1437553302 | Raleigh Durham Medical Group, Pa | Family Medicine | 620 Dr Calvin Jones Highway, Ste 212, Wake Forest, NC 27587 | 2014-10-21 |
| Find all providers in zip 27587 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588830053 | Patricia N Maness | Nurse Practitioner | 350 E Holding Ave, Wake Forest, NC 27587-2904 | 2008-05-05 |
| 1053500363 | Deborah Hupp | Nurse Practitioner | 245 East Roosevelt Ave, Minuteclinic Diagnostic of North Carolina, Wake Forest, NC 27587 | 2007-10-23 |
| 1336348689 | Casandra Grace Chapman-corey | Nurse Practitioner | 2832 Kimmon Way, Wake Forest, NC 27587-5442 | 2007-07-17 |
| 1366428393 | Monica M Capp | Nurse Practitioner | 851 Durham Rd, Ste D, Wake Forest, NC 27587-8793 | 2005-12-21 |
| 1134116437 | April Lynne Goley | Nurse Practitioner | 1002 Durham Rd, Suite 800, Wake Forest, NC 27587-9118 | 2005-10-02 |
| 1639733900 | Subbulakshmi Settu | Nurse Practitioner | 245 E Roosevelt Ave, Wake Forest, NC 27587-2719 | 2019-04-23 |
| 1538673470 | Sude Abdulahi | Nurse Practitioner | 245 E Roosevelt Ave, Wake Forest, NC 27587-2719 | 2017-11-30 |
| 1831638279 | Lyndsey Bennett | Nurse Practitioner | 3150 Rogers Rd Ste 101, Wake Forest, NC 27587-4196 | 2017-02-17 |
| 1679945687 | Alicia Lynn Gray | Nurse Practitioner | 11635 Northpark Dr, Suite 200, Wake Forest, NC 27587-6526 | 2015-10-29 |
| 1689056806 | Jennifer Lynn Tangeman | Nurse Practitioner | 120 Capcom Ave, Wake Forest, NC 27587-6537 | 2015-06-24 |
| Find all providers in WAKE FOREST | ||||
| City | WAKE FOREST |
| Zip Code | 27587 |
Please comment or provide details below to improve the information on WENDELL CLAVONN JOHN.
| 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.