NPIMap

Organization Active NPI

Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Apex, NC
National Provider Identifier
1043492853
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
WAKE EMERGENCY PHYSICIANS PA
Practice address
120 Healthplex Way
Apex, NC 27502
Phone
(843) 237-3378
Fax
(843) 237-5073
NPI assigned
Dec 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Authorized official

Name
Dr. Jennifer Raley, MD
Title
Administrator
Phone
(919) 859-3373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X NC Primary

Addresses

Primary practice location

120 Healthplex Way
Apex, NC 27502

Mailing address

PO Box 890053
Charlotte, NC 28289-0053
Phone (843) 237-3378

Other identifiers 3

IdentifierTypeStateIssuer
0298NOtherNCBCBS
0295FOtherNCBCBS STATE
CD5224OtherNCRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000295 NC Part B Supplier - Clinic/Group Practice 9931002078 Receives reassigned benefits from 296 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rocky Mount, NC; Wendell, NC; Smithfield, NC; Raleigh, NC; Kinston, NC; Goldsboro, NC; Garner, NC; Clayton, NC…

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory

Locations

120 Healthplex Way
Apex, NC 27502
Phone (919) 235-6525

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1043492853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890053",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890053",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTHPLEX WAY",
            "city": "APEX",
            "state": "NC",
            "postal_code": "27502",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE EMERGENCY PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "RALEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-859-3373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0298N",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS STATE",
            "identifier": "0295F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD5224",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.