Wakemed Specialists Group, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WAKEMED SPECIALISTS GROUP, LLC

Practice address

601 Oberlin Rd
Raleigh, NC 27605-1126

Phone

(919) 789-4322

Fax

(919) 789-4533

NPI assigned

May 3, 2019

Organization subpart

No

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

Authorized official

Name

Shondra Lynn Brink

Title

VP of Operations

Phone

(919) 350-6045

Specialties & licenses 2

Addresses

Other names 1

• WakeMed Urgent Care Other name

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

Locations

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1013572213",
    "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": "919-350-0552",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 OBERLIN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051126",
            "telephone_number": "919-789-4322",
            "fax_number": "919-789-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEMED SPECIALISTS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-03",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "SHONDRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "919-350-6045"
    },
    "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": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WakeMed Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wakemed Specialists Group LLC
• Wakemed Specialists Group LLC
• Wakemed Specialists Group LLC
• Wakemed Specialists Group LLC
• Wakemed Specialists Group, LLC
• Wakemed Specialists Group, LLC
• Wakemed Specialists Group, LLC
• Wakemed Specialists Group, LLC
• Wakemed Specialists Group, LLC
• Wakemed Specialists Group, LLC

• All providers in Raleigh, NC
• 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 Jan 15, 2021; 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.