WAKE SPECIALTY PHYSICIANS LLC NPI 1255851424

NPI Information

  • NPI: 1255851424
  • Provider Name: WAKE SPECIALTY PHYSICIANS LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: WAKEMED PRIMARY CARE FORESTVILLE CROSSING
  • CLIA Number: 34D2137661
  • Address: 2930 FORESTVILLE RD
    RALEIGH, NC
    ZIP 27616
  • Phone: (919) 235-6550

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NPI Details

WAKE SPECIALTY PHYSICIANS LLC is a family medicine in Raleigh, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WAKE SPECIALTY PHYSICIANS LLC NPI is 1255851424. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wakemed Primary Care Forestville Crossing.

The provider's business location address is:

2930 FORESTVILLE RD
RALEIGH, NC
ZIP 27616-774
Phone: (919) 235-6550
Fax: (919) 235-6586

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 34D2137661 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/20/2017 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineNo
2207Q00000XFamily 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11255851424MEDICAIDNORTH 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: 11/21/2025

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