Wake Spine and Pain Specialists, PC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

WAKE SPINE AND PAIN SPECIALISTS, PC

Practice address

1511 Westover Ter Ste 107
Greensboro, NC 27408-7122

Phone

(336) 398-5155

Fax

(336) 398-5156

NPI assigned

Apr 22, 2022

Organization subpart

Yes

Parent organization

WAKE SPINE AND PAIN SPECIALISTS, PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vijaysinha Mandhare

Title

Medical Director

Phone

(919) 787-7246

Specialties & licenses 1

Addresses

Part of

Wake Spine Pain Specialist

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CIJHAA

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wake Spine & Pain Specialists PC

  • Pain Medicine (Anesthesiology) Physician
  • Cary, NC
  • NPI 1568696748
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1003550443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WAKE FOREST RD STE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096864",
            "telephone_number": "919-787-7246",
            "fax_number": "919-787-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 WESTOVER TER STE 107",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087122",
            "telephone_number": "336-398-5155",
            "fax_number": "336-398-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE SPINE AND PAIN SPECIALISTS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE SPINE AND PAIN SPECIALISTS, PC",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "MANDHARE",
        "authorized_official_first_name": "VIJAYSINHA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "919-787-7246"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wake Forest University Health Sciences
• Wake Forest University Health Sciences
• Wake Forest University Health Sciences
• Wake Forest University Health Sciences
• Wake Forest University Health Sciences
• Matthew Charles Wakefield
• Wal-Mart
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP

• All providers in Greensboro, NC
• Pain Medicine (Anesthesiology) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.