Wakemed Specialists Group, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WAKEMED SPECIALISTS GROUP, LLC

Practice address

231 N Judd Pkwy NE
Fuquay Varina, NC 27526-2694

Phone

(919) 235-6560

Fax

(919) 235-6597

NPI assigned

Nov 11, 2019

Organization subpart

No

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

Authorized official

Name

Maria Jayoussi

Title

Executive Director of Finance

Phone

(919) 350-6089

Specialties & licenses 2

Addresses

Other names 1

• WakeMed Urgent Care Doing business as

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Wakemed

  • Home Health Agency
  • Raleigh, NC
  • NPI 1467435842

  Member Of

  NPD member

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573430400000",
    "number": "1013552322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "919-350-0554",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N JUDD PKWY NE",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262694",
            "telephone_number": "919-235-6560",
            "fax_number": "919-235-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEMED SPECIALISTS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A",
        "authorized_official_last_name": "JAYOUSSI",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "919-350-6089"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WakeMed Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wake Specialty Physicians LLC
• Wake Specialty Physicians LLC
• Wake Specialty Physicians LLC
• Wakemed Specialists Group LLC
• Wakemed Specialists Group LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Laura Waldo, BCHN
• Walgreen Co
• Walgreen Co

• Durable Medical Equipment & Medical Supplies in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.