Provider Type Icon

WAKE SPECIALTY PHYSICIANS LLC NPI 1710434691


NPI Information

NPI: 1710434691
Provider Name: WAKE SPECIALTY PHYSICIANS LLC

Doing Business As: WAKEMED PHYSICIAN PRACTICES PEDIATRIC WEIGHT MANAGEMENT

Classification: Pediatrics - 2080B0002X
Entity Type: Organization

Specialization: Obesity Medicine

Address:
23 SUNNYBROOK RD
RALEIGH, NC
ZIP 27610
Phone: (919) 350-6439
Get Directions

WAKE SPECIALTY PHYSICIANS LLC is an obesity medicine pediatrics in Raleigh, NC. The provider is 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. WAKE SPECIALTY PHYSICIANS LLC NPI is 1710434691. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wakemed Physician Practices Pediatric Weight Management.

The provider's business location address is:

23 SUNNYBROOK RD
RALEIGH, NC
ZIP 27610-855
Phone: (919) 350-6439
Fax: (919) 231-0314

The provider's authorized official is Maria Jayoussi .
The authorized official title is Executive Director, Finance and has the following contact phone number (919) 350-6089.

The enumeration date for this NPI number is 9/8/2016 and was last updated on 6/16/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsNORTH CAROLINANo
22080B0002XPediatricsObesity MedicineNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11942440373MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.