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Organization Active NPI

Wakemed Faculty Practice Plan

Doing business as WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists

  • Pediatric Critical Care Medicine Physician
  • Raleigh, NC
National Provider Identifier
1013203819
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Legal business name
WAKEMED FACULTY PRACTICE PLAN
Doing business as
WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists
Practice address
3024 New Bern Ave
Raleigh, NC 27610-1247
Phone
(919) 350-8000
NPI assigned
Jun 21, 2011
Last updated
Jul 5, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
WAKEMED FACULTY PRACTICE PLANAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Authorized official

Name
Dr. Susan Tucker Weaver, M.D.NPI 1649324914
Title
Senior Vice President
Phone
(919) 350-8228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X NU
Pediatric Critical Care Medicine Physician 2080P0203X NU Primary
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

3024 New Bern Ave
Raleigh, NC 27610-1247

Mailing address

3024 New Bern Ave
Raleigh, NC 27610-1247
Phone (919) 350-8000

Other names 1

  • WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists Doing business as

National Provider Directory

National Provider Directory
Part of
Wakemed Faculty Practice

Locations

200 Ashville Ave
Ste 30
Cary, NC 27518
Phone (919) 350-2580

400 US 70 Hwy E
Ste 200
Garner, NC 27529
Phone (919) 235-6400

10010 Falls of Neuse Rd
Ste 307
Raleigh, NC 27614
Phone (919) 847-3164

11550 Common Oaks Dr
Ste 106
Raleigh, NC 27614
Phone (919) 350-1380

23 Sunnybrook Rd
Ste 197
Raleigh, NC 27610
Phone (919) 350-8712

3000 New Bern Ave
Ste 1130
Raleigh, NC 27610
Phone (919) 350-2800

3019 Falstaff Rd
Raleigh, NC 27610
Phone (919) 250-7000

8001 T W Alexander Dr
#220
Raleigh, NC 27617
Phone (919) 781-7772

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 261

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.

View all 261

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1013203819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEMED FACULTY PRACTICE PLAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKEMED FACULTY PRACTICE PLAN",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "TUCKER",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "919-350-8228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.