NPIMap

Organization Active NPI

Raleigh Durham Medical Group PA

Doing business as Waverly Primary Care

  • Family Medicine Physician
  • Cary, NC
National Provider Identifier
1003868258
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Doing business as
Waverly Primary Care
Practice address
600 New Waverly Place
Ste 203
Cary, NC 27518
Phone
(919) 859-5650
Fax
(919) 859-5695
NPI assigned
May 16, 2006
Last updated
Mar 7, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
RALEIGH DURHAM MEDICAL GROUP PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
David K Moye
Title
Senior Vice President
Phone
(919) 614-0301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

600 New Waverly Place
Ste 203
Cary, NC 27518

Mailing address

PO Box 96860
Charlotte, NC 28296-6860
Phone (919) 233-5952

Other identifiers 2

IdentifierTypeStateIssuer
5900362MedicaidNC
0231TOtherNCBCBS

Other names 1

  • Waverly Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041220000155 NC Part B Supplier - Clinic/Group Practice 2365409588 Receives reassigned benefits from 103 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC; Four Oaks, NC; Greenville, NC; Morrisville, NC; Raleigh, NC; Wake Forest, NC; Cary, NC; Fayetteville, NC…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1041060Waverly Primary Care600 New Waverly Place Ste 203, Cary, NC 27518Provider-performed microscopyMay 23, 2027

National Provider Directory

National Provider Directory
Part of
Raleigh Durham Medical

Locations

100 Cunningham Ln
Clayton, NC 27527
Phone (919) 359-1011

Interoperability endpoints

  • Direct secure messaging: charliefoster@waprcre.allscriptsdirect.net
  • Direct secure messaging: jingzhang@waprcre.allscriptsdirect.net
  • Direct secure messaging: scottbrundle@waprcre.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1003868258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96860",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282966860",
            "telephone_number": "919-233-5952",
            "fax_number": "312-324-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NEW WAVERLY PLACE",
            "address_2": "STE 203",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-859-5650",
            "fax_number": "919-859-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH DURHAM MEDICAL GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RALEIGH DURHAM MEDICAL GROUP PA",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "MOYE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "919-614-0301"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900362",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0231T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waverly Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waverly Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.