NPIMap

Wake Forest Health Network, LLC

Organization Active NPI Pediatrics Physician · Greensboro, NC

NPI 1053175299 · NPPES record last updated Sep 25, 2025

Key facts

NPI
1053175299
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
WAKE FOREST HEALTH NETWORK, LLC
Practice address
4529 Jessup Grove Rd
Greensboro, NC 27410-9407
Phone
(336) 605-0190
Fax
(336) 605-0930
NPI assigned
Feb 8, 2024
Organization subpart
Yes
Parent organization (as reported)
WAKE FOREST HEALTH NETWORK, LLC

Authorized official

Name
Craig Michael Greven
Title
Sr VP Clinical Operations
Phone
(336) 716-1331

Corporate family (same tax ID) 19

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 688

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

View all 688

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031117000868 NC Part B Supplier - Clinic/Group Practice 4183538895 Receives reassigned benefits from 690 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: High Point, NC; Jefferson, NC; Jonesville, NC; Kernersville, NC; Summerfield, NC; Thomasville, NC; Winston Salem, NC; Archdale, NC…

National Provider Directory

Tax ID family
Corerstone HLTH Care (55 organizations share this tax ID)
Part of
Corerstone HLTH Care

Locations (25 of 39)

542 White Oak St
Ste A
Asheboro, NC 27203
Phone (336) 629-4176

197 Stadium Oaks Dr
#A
Clemmons, NC 27012
Phone (336) 293-4819

802 Green Valley Rd
Ste 210
Greensboro, NC 27408
Phone (336) 510-5510

4515 Premier Dr
Ste 301
High Point, NC 27265

400 N Elm St
High Point, NC 27262
Phone (336) 802-2120

1208 Eastchester Dr
Ste 107
High Point, NC 27265
Phone (336) 802-2588

624 Quaker Ln
Ste 100E
High Point, NC 27262
Phone (336) 878-6042

308B Boulevard St
High Point, NC 27262
Phone (336) 802-2185

1814 Westchester Dr
Ste 301A
High Point, NC 27262
Phone (336) 802-2170

624 Quaker Ln
Ste D101
High Point, NC 27262
Phone (336) 802-2145

624 Quaker Ln
Ste 200C
High Point, NC 27262
Phone (336) 802-2050

1011 N Lindsay St
Ste 202
High Point, NC 27262
Phone (336) 886-1667

318 Westwood Ave
High Point, NC 27262
Phone (336) 802-2065

308 Boulevard St
#A
High Point, NC 27262
Phone (336) 802-2175

4515 Premier Dr
#100
High Point, NC 27265
Phone (336) 802-2250

4515 Premier Dr
Ste 300A
High Point, NC 27265
Phone (336) 802-2080

624 Quaker Ln
Ste 100D
High Point, NC 27262
Phone (336) 802-2090

624 Quaker Ln
Ste D200
High Point, NC 27262
Phone (336) 802-2291

624 Quaker Ln
Ste 201A
High Point, NC 27262
Phone (336) 884-8444

624 Quaker Ln
Ste 101A
High Point, NC 27262
Phone (336) 884-8444

624 Quaker Ln
Ste 104C
High Point, NC 27262
Phone (336) 802-2397

708 N Elm St
High Point, NC 27262
Phone (336) 802-2130

624 Quaker Ln
Ste 210A
High Point, NC 27262
Phone (336) 884-8444

4515 Premier Dr
Ste 202A
High Point, NC 27265
Phone (336) 802-2117

4510 Premier Dr
Ste 101
High Point, NC 27265
Phone (336) 802-2210

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X Yes

Addresses

Primary practice location

4529 Jessup Grove Rd
Greensboro, NC 27410-9407

Mailing address

4529 Jessup Grove Rd
Greensboro, NC 27410-9407
Phone (336) 605-0190

Other names

  • Atrium Health Levine Children's Pediatrics Northwest Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Other providers in Greensboro, NC

All providers in Greensboro, NC · Pediatrics Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.