WAKE FOREST BAPTIST IMAGING LLC NPI 1700490232

NPI Information

  • NPI: 1700490232
  • Provider Name: WAKE FOREST BAPTIST IMAGING, LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Doing Business As: ATRIUM HEALTH WAKE FOREST BAPTIST IMAGING - KERNERSVILLE
  • CLIA Number: 34D1007881
  • Address: 861 OLD WINSTON RD STE 105
    KERNERSVILLE, NC
    ZIP 27284
  • Phone: (336) 765-5722

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NPI Details

WAKE FOREST BAPTIST IMAGING, LLC is a diagnostic radiology radiology in Kernersville, NC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. WAKE FOREST BAPTIST IMAGING, LLC NPI is 1700490232. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Atrium Health Wake Forest Baptist Imaging - Kernersville.

The provider's business location address is:

861 OLD WINSTON RD STE 105
KERNERSVILLE, NC
ZIP 27284-141
Phone: (336) 765-5722
Fax: (336) 765-5723

The provider's authorized official is Amy Stout .
The authorized official title is President/ceo and has the following contact phone number (615) 261-2306.

The CLIA number assigned to this NPI record is 34D1007881 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/2/2020 and was last updated on 12/10/2024.

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
12085R0202XRadiologyDiagnostic RadiologyYes

What is NPI?

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This page was last updated on: 3/30/2025

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