WAKE FOREST HEALTH NETWORK LLC NPI 1124265236

NPI Information

  • NPI: 1124265236
  • Provider Name: WAKE FOREST HEALTH NETWORK LLC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • :
  • CLIA Number: 34D0867298
  • Address: 114 KINDERTON BLVD
    BERMUDA RUN, NC
    ZIP 27006
  • Phone: (336) 998-9742

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NPI Details

WAKE FOREST HEALTH NETWORK LLC is a pediatrics in Bermuda Run, 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 1124265236. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

114 KINDERTON BLVD
BERMUDA RUN, NC
ZIP 27006-302
Phone: (336) 998-9742
Fax: (336) 998-9410

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 34D0867298 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/12/2009 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

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CB8658OTHERNORTH CAROLINARR MEDICARE
2CC4241OTHERNORTH CAROLINARR MEDICARE
3CD6614OTHERNORTH CAROLINARR MEDICARE
45912346MEDICAIDNORTH CAROLINA
5CC4243OTHERNORTH CAROLINARR MEDICARE

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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