Willard Lee Kennedy (NPI# 1649279696, PAC ID# 8820178189) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1649279696 |
| PAC ID by PECOS | 8820178189 |
| Professional Enrollment ID | I20100726000721 |
| Full Name | Willard Lee Kennedy |
| Organization Legal Name | WAKE SPECIALTY PHYSICIANS LLC |
| Address |
3324 Six Forks Rd Raleigh NC 27609-7233 |
| Phone Number | 9197817772 |
| Gender | M |
| Medical School | BOWMAN GRAY SCHOOL OF MEDICINE OF WAKE FOREST UNIVERSITY |
| Graduation Year | 1975 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Group Practice PAC ID | 7416006085 |
| Number of Group Practice Members | 484 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340069 | WAKEMED, RALEIGH CAMPUS |
| 340114 | REX HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3324 Six Forks Rd, Raleigh, NC 27609-7233 | 9197817772 | WAKE SPECIALTY PHYSICIANS LLC |
| Organization Legal Name | WAKE SPECIALTY PHYSICIANS LLC |
| Physicians | 129 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen Randolph Tibbels | Family Medicine | Wake Specialty Physicians LLC | 2930 Forestville Rd, Raleigh, NC 27616-8774 |
| Sheree D. Givre | Internal Medicine | Wake Specialty Physicians LLC | 2406 Blue Ridge Rd, Raleigh, NC 27607-6678 |
| Kelechi C Uwakwe | Nurse Practitioner | Wake Specialty Physicians LLC | 150 E Davie St, Raleigh, NC 27601-1806 |
| Jewell Elizabeth Whitmer | Certified Nurse Midwife (cnm) | Wake Specialty Physicians LLC | 204 Ashville Ave, Cary, NC 27518-6670 |
| Shahla Naz | Family Medicine | Wake Specialty Physicians LLC | 101 Cotten Ln, Holly Springs, NC 27540-8415 |
| Pamela L Borden | Certified Nurse Midwife | Wake Specialty Physicians LLC | 208 Ashville Ave, Cary, NC 27518-6678 |
| Swapna V Chenna | Family Medicine | Wake Specialty Physicians LLC | 231 N Judd Pkwy Ne, Fuquay Varina, NC 27526-2694 |
| Dustin Pierson | Family Medicine | Wake Specialty Physicians LLC | 7124 Knightdale Blvd, Knightdale, NC 27545-9265 |
| Adija D Bailey | Physician Assistant | Wake Specialty Physicians LLC | 901 Old Knight Rd, Knightdale, NC 27545-9065 |
| Michael F Soboeiro | Internal Medicine | Wake Specialty Physicians LLC | 400 Us Hwy 70 E, Garner, NC 27529 |
| Street Address |
3324 SIX FORKS RD |
| City | RALEIGH |
| State | NC |
| Zip | 27609-7233 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory T Anderson | Nurse Practitioner | Wakemed Specialists Group, LLC | 3324 Six Forks Rd, Raleigh, NC 27609-7233 |
| Terri Mcdowell | Nurse Practitioner | Wakemed Specialists Group, LLC | 3324 Six Forks Rd, Raleigh, NC 27609-7233 |
| Jeffrey Robert Blackburn | Cardiovascular Disease (cardiology) | Wakemed Specialists Group, LLC | 3324 Six Forks Rd, Raleigh, NC 27609-7233 |
| Jack W Noneman Jr. | Cardiovascular Disease (cardiology) | Wakemed Specialists Group, LLC | 3324 Six Forks Rd, Raleigh, NC 27609-7233 |
| Padma Bala Hari | Cardiovascular Disease (cardiology) | Wakemed Specialists Group, LLC | 3324 Six Forks Rd, Raleigh, NC 27609-7233 |
| Siddhartha A Rao | Interventional Cardiology | Wakemed Specialists Group, LLC | 3324 Six Forks Rd, Raleigh, NC 27609-7233 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ezra B Wilkins | Family Medicine | 4020 Wake Forest Rd, Suite 201, Raleigh, NC 27609-0009 | |
| April Myers Risinger | Physician Assistant | E Brooks Wilkins Family Medicine Pa | 4020 Wake Forest Rd, Suite 201, Raleigh, NC 27609-0009 |
| Nancy V Cross | Internal Medicine | E Brooks Wilkins Family Medicine Pa | 4020 Wake Forest Rd, Suite 201, Raleigh, NC 27609-0009 |
| Henry J Vanpala | Internal Medicine | 1631 Midtown Pl, Suite 101, Raleigh, NC 27609-1300 | |
| Richard A Laviano | Chiropractic | 6009 Falls of Neuse Rd, Raleigh, NC 27609-3525 | |
| Jeffrey William Brower | Chiropractic | Brower Chiropractic Center | 6009 Falls of Neuse Rd, Raleigh, NC 27609-3525 |
| Mary A Alexander | Internal Medicine | Duke University Affiliated Physicians Inc | 5920 Sandy Forks Rd, Suite 100, Raleigh, NC 27609-3814 |
| Alyssa R Krueger | Family Medicine | Duke University Affiliated Physicians Inc | 5920 Sandy Forks Rd, Suite 100, Raleigh, NC 27609-3814 |
| Natalie J Mclaughlin | Nurse Practitioner | Duke University Affiliated Physicians Inc | 5920 Sandy Forks Rd, Suite 100, Raleigh, NC 27609-3814 |
| Isabella D Bentsen | Internal Medicine | Duke University Affiliated Physicians Inc | 5920 Sandy Forks Rd, Suite 100, Raleigh, NC 27609-3814 |
| Find all physicians in zip 27609 | |||
| City | RALEIGH |
| Zip Code | 27609 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | RALEIGH + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.