WAKEMED SPECIALISTS GROUP, LLC (NPI# 1962067314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962067314 |
| Entity Type | Organization |
| Organization Name | WAKEMED SPECIALISTS GROUP, LLC |
| Other Organization Name | WAKEMED CHILDRENS PEDIATRIC WEIGHT MANAGEMENT |
| Practice Address |
23 Sunnybrook Rd Raleigh NC 27610-1855 |
| Mailing Address |
Po Box 603949 Charlotte NC 28260-3949 |
| Practice Telephone | 9192356439 |
| Practice Fax Number | 9192310314 |
| Mailing Telephone | 9193500552 |
| Mailing Fax Number | 9193507687 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-08-19 |
| Authorized Official Name | MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 9193506089 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080B0002X |
Pediatrics Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WakeMed Children's-Pediatric Weight Management | Other Name - Individual/Organization |
| WakeMed Childrens Pediatric Weight Management | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326681164 | Wakemed Specialists Group, LLC | Durable Medical Equipment & Medical Supplies | 2930 Forestville Rd Ste 100, Raleigh, NC 27616-8774 | 2019-10-24 |
| 1407409543 | Wakemed Specialists Group, LLC | Pediatrics | 104 Medspring Dr, Clayton, NC 27520-9687 | 2019-07-18 |
| 1114582301 | Wakemed Specialists Group, LLC | Physical Therapist | 10010 Falls of Neuse Rd Ste 9, Raleigh, NC 27614-8495 | 2019-05-03 |
| 1376108522 | Wakemed Specialists Group, LLC | Orthopaedic Surgery | 8001 T W Alexander Dr Ste 224, Raleigh, NC 27617-4884 | 2019-05-03 |
| 1326684077 | Wakemed Specialists Group, LLC | Clinic/Center | 811 Us 70 Hwy W, Garner, NC 27529-2541 | 2019-11-18 |
| 1013552322 | Wakemed Specialists Group, LLC | Clinic/Center | 231 N Judd Pkwy Ne, Fuquay Varina, NC 27526-2694 | 2019-11-11 |
| 1588225759 | Wakemed Specialists Group, LLC | Preventive Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-06-27 |
| 1184289159 | Wakemed Specialists Group, LLC | Clinic/Center | 222 Ashville Ave Ste 10, Cary, NC 27518-6130 | 2019-05-06 |
| 1992360960 | Wakemed Specialists Group, LLC | Orthopaedic Surgery | 400 Us Highway 70 E, Ste 100, Garner, NC 27529-4850 | 2019-05-06 |
| 1720643927 | Wakemed Specialists Group, LLC | Otolaryngology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
| Street Address |
23 SUNNYBROOK RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-1855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386648756 | James A Scovil | Legal Medicine | 23 Sunnybrook Rd, Ste 109, Raleigh, NC 27610-1855 | 2005-06-13 |
| 1861030371 | Macon Louise Cornick Guidry | Dietitian, Registered | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-12-16 |
| 1679129720 | Amelia Willis | Nurse Practitioner | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-08-14 |
| 1497307334 | Wakemed Specialists Group LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-07-11 |
| 1336704766 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1265097695 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1245895697 | Wakemed Specialists Group, LLC | Counselor | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1982269346 | Wakemed Specialists Group, LLC | Surgery | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1659934511 | Wake Specialty Physicians, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-04-17 |
| 1568958866 | Allison Sharp Mcdougal | Dietitian, Registered | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2018-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
| 1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
| 1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
| 1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
| 1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
| 1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
| 1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| 1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
| 1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
| Find all providers in zip 27610 | ||||
| Taxonomy Code | 2080B0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Obesity Medicine |
| A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. |
| Notes: Source: American Board of Obesity Medicine, www.abom.org [7/1/2015: new] Additional Resource: American Society of Bariatric Physicians, www.asbp.org. |
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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.