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WAKE SPECIALTY PHYSICIANS LLC NPI 1134530074


NPI Information

NPI: 1134530074
Provider Name: WAKE SPECIALTY PHYSICIANS LLC

Doing Business As: WAKEMED PRIMARY CARE NORTH RALEIGH

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 34D1032130

Address:
10010 FALLS OF NEUSE RD
RALEIGH, NC
ZIP 27614
Phone: (919) 848-6946
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WAKE SPECIALTY PHYSICIANS LLC is an internal medicine in Raleigh, NC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. WAKE SPECIALTY PHYSICIANS LLC NPI is 1134530074. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wakemed Primary Care North Raleigh.

The provider's business location address is:

10010 FALLS OF NEUSE RD
RALEIGH, NC
ZIP 27614-494
Phone: (919) 848-6946
Fax: (919) 848-4899

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

The CLIA number assigned to this NPI record is 34D1032130 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/14/2014 and was last updated on 8/8/2019.


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
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineYes

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
11134530074MEDICAIDNORTH 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

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