NPIMap

Organization Active NPI

NC Preventative Medicine and Wellness Clinic

  • Obesity Medicine (Family Medicine) Physician
  • Raleigh, NC
National Provider Identifier
1053739375
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
Legal business name
NC PREVENTATIVE MEDICINE AND WELLNESS CLINIC
Practice address
1911 Falls Valley Dr
Suite 105
Raleigh, NC 27615-2495
Phone
(919) 249-4600
NPI assigned
Apr 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Authorized official

Name
Wendy Jones
Title
Regional Business Manager
Phone
(980) 721-2675

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QB0002X Primary

Addresses

Primary practice location

1911 Falls Valley Dr
Suite 105
Raleigh, NC 27615-2495

Mailing address

1911 Falls Valley Dr
Suite 105
Raleigh, NC 27615-2495
Phone (919) 249-4600

National Provider Directory

National Provider Directory
Tax ID family
NC Preventative Medicine and Wellness Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1053739375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 FALLS VALLEY DR",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152495",
            "telephone_number": "919-249-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 FALLS VALLEY DR",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152495",
            "telephone_number": "919-249-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NC PREVENTATIVE MEDICINE AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "REGIONAL BUSINESS MANAGER",
        "authorized_official_telephone_number": "980-721-2675"
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 3, 2014; 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.