WAKEMED SPECIALISTS GROUP, LLC


Address: 23 Sunnybrook Rd, Raleigh, NC 27610-1855
Phone: 9193508797

WAKEMED SPECIALISTS GROUP, LLC (NPI# 1982269346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1982269346
Entity Type Organization
Organization Name WAKEMED SPECIALISTS GROUP, LLC
Other Organization Name WAKEMED CHILDRENS PEDIATRIC SURGERY
Practice Address 23 Sunnybrook Rd
Raleigh
NC 27610-1855
Mailing Address Po Box 603949
Charlotte
NC 28260-3949
Practice Telephone 9193508797
Practice Fax Number 9193507859
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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0120X Surgery
Specialization: Pediatric Surgery
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
WakeMed Children's-Pediatric Surgery Other Name - Individual/Organization
WakeMed Childrens Pediatric Surgery Other Name - Individual/Organization

Other Provider IDs and Locations

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

Office Location

Street Address 23 SUNNYBROOK RD
City RALEIGH
State NC
Zip Code 27610-1855

Providers in the same location

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
1962067314 Wakemed Specialists Group, LLC Pediatrics 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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2086S0120X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Pediatric Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1225525538 Jessica Marie Pierce Surgery 1900 Randolph Rd Ste 210, Charlotte, NC 28207-1106 2018-04-23
1750695078 Pamela Artise Patrick-roberts Surgery N Carolina Baptist Hospital, Medical Center Blvd, Winston Salem, NC 27157-0001 2010-07-28
1346376423 Daniel Andrew Bambini Surgery 1900 Randolph Rd., Ste. 210, Charlotte, NC 28207-1106 2007-02-26
1821085838 Gregory Hoy Surgery 105 Wando Cir, Hertford, NC 27944-8951 2005-10-04
1194157388 Carolinas Physicians Network Inc Surgery 1025 Morehead Medical Dr, Ste 275, Charlotte, NC 28204-2963 2013-07-30
1730520396 Carolinas Physicians Network Inc Surgery 100 Medical Park Dr, Ste 310, Concord, NC 28025-2948 2013-07-11
1134447378 Carolina Healthcare Associates Inc Surgery 2131 S 17th St, Wilmington, NC 28401-7407 2010-05-12
1740441088 Leah M Sieren Surgery Medical Center Blvd, Winston Salem, NC 27157-0001 2008-06-19
1275741076 Graham Harvey Cosper Surgery 1900 Randolph Rd., Ste. 210, Charlotte, NC 28207-1106 2007-05-18
1669691168 Jeffrey Dehmer Surgery 2131 S 17th St, Wilmington, NC 28401-7407 2007-04-24
Find all providers with the same taxonomy

Competitor

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City RALEIGH
Zip Code 27610

Improve Information

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Dataset Information

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.

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