WAKEMED SPECIALISTS GROUP LLC NPI 1790343366

NPI Information

  • NPI: 1790343366
  • Provider Name: WAKEMED SPECIALISTS GROUP LLC
  • Classification: Pediatrics - 2080N0001X
  • Specialization: Neonatal-Perinatal Medicine
  • Entity Type: Organization
  • :
  • Address: 3024 NEW BERN AVE
    RALEIGH, NC
    ZIP 27610
  • Phone: (919) 350-7846

Map and Directions

Get Directions

NPI Details

WAKEMED SPECIALISTS GROUP LLC is a neonatal-perinatal medicine pediatrics in Raleigh, NC. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. WAKEMED SPECIALISTS GROUP LLC NPI is 1790343366. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider .

The provider's business location address is:

3024 NEW BERN AVE
RALEIGH, NC
ZIP 27610-247
Phone: (919) 350-7846
Fax: (919) 350-8147

The provider's authorized official is Karen Revicki Perry .
The authorized official title is Sled and has the following contact phone number (919) 350-8000.

The enumeration date for this NPI number is 5/30/2019 and was last updated on 7/23/2025.

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
1208000000XPediatricsNo
22080N0001XPediatricsNeonatal-Perinatal 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
11790343366MEDICAIDNORTH 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: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI