WAKE FOREST HEALTH NETWORK LLC NPI 1053175299

NPI Information

  • NPI: 1053175299
  • Provider Name: WAKE FOREST HEALTH NETWORK, LLC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • :
  • CLIA Number: 34D2288218
  • Address: 4529 JESSUP GROVE RD
    GREENSBORO, NC
    ZIP 27410
  • Phone: (336) 605-0190

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NPI Details

WAKE FOREST HEALTH NETWORK, LLC is a pediatrics in Greensboro, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. WAKE FOREST HEALTH NETWORK, LLC NPI is 1053175299. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

4529 JESSUP GROVE RD
GREENSBORO, NC
ZIP 27410-407
Phone: (336) 605-0190
Fax: (336) 605-0930

The provider's authorized official is Craig Michael Greven .
The authorized official title is Sr Vp Clinical Operations and has the following contact phone number (336) 716-1331.

The CLIA number assigned to this NPI record is 34D2288218 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/8/2024 and was last updated on 9/25/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsYes

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: 11/21/2025

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