Wake Forest Health Network, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WAKE FOREST HEALTH NETWORK, LLC

Doing business as

Cornerstone Laboratory Services

Practice address

1814 Westchester Dr
Suite 400
High Point, NC 27262-7010

Phone

(336) 802-2130

Fax

(336) 802-2131

NPI assigned

Jun 8, 2006

Last updated

Sep 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russell Mars Howerton

Title

Sr VP Network Phys & HS Cmo

Phone

(336) 716-1331

Specialties & licenses 12

Addresses

Other identifiers 9

Other names 1

• Cornerstone Laboratory Services Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacy Griffin Bachmann, PA

  • Medical Physician Assistant
  • High Point, NC
  • NPI 1447208681
  NPD (past)
• Rami Jamil Badreddine, MD

  • Gastroenterology Physician
  • High Point, NC
  • NPI 1063439982
  NPD (past)
• Lucy Pinson Barden, PA-C

  • Physician Assistant
  • Jamestown, NC
  • NPI 1457387789
  NPD (past)
• Robert Edward Bednar Jr., PA-C

  • Physician Assistant
  • Winston Salem, NC
  • NPI 1437212651
  NPD (past)
• Misty Hochrein Bitting, PA-C

  • Medical Physician Assistant
  • Pinehurst, NC
  • NPI 1609806801
  NPD (past)
• Justin Blaylock, P.A.

  • Physician Assistant
  • High Point, NC
  • NPI 1871548909
  NPD (past)
• Yuri Milton Cabeza, MD

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1558484931
  NPD (past)
• Paul Edward Craft, PA

  • Physician Assistant
  • Jamestown, NC
  • NPI 1376573535
  NPD (past)
• Ann Teass Currin, PA-C

  • Physician Assistant
  • High Point, NC
  • NPI 1316966989
  NPD (past)
• Mark D. Doner, MD

  • Pulmonary Disease Physician
  • High Point, NC
  • NPI 1538189022
  NPD (past)
• Michael T. Draelos, MD

  • Gastroenterology Physician
  • High Point, NC
  • NPI 1104842665
  NPD (past)
• Muhammad Shakir Ejaz, M.D

  • Pulmonary Disease Physician
  • High Point, NC
  • NPI 1871817148
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1063453553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-1331",
            "fax_number": "336-716-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 WESTCHESTER DR",
            "address_2": "SUITE 400",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627010",
            "telephone_number": "336-802-2130",
            "fax_number": "336-802-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST HEALTH NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "HOWERTON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "MARS",
        "authorized_official_title_or_position": "SR VP NETWORK PHYS & HS CMO",
        "authorized_official_telephone_number": "336-716-1331"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC5472",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC4241",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC4242",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC6608",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7001156",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB8658",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD6614",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF9200",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC4243",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Laboratory Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cornerstone Laboratory Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wake Forest Health Network LLC (Atrium Health Wake Forest Baptist Internal Medicine - Westchester)
• Wake Forest Health Network LLC (Atrium Health Wake Forest Baptist Clinical Pharmacy & Diabetes/Nutriti)
• Wake Forest Health Network LLC (Atrium Health Wake Forest Baptist Neurology - Westchester)
• Wake Forest Health Network LLC (Atrium Health Wake Forest Baptist Rheumatology - Westchester)
• Wake Forest Health Network LLC (Atrium Health Wake Forest Baptist Behavioral Medicine - Premier)
• Wake Forest Health Network, LLC (Atrium Health Wake Forest Baptist Family Medicine - Premier)
• Wake Forest University Health Sciences
• Wake Forest University Health Sciences
• Wake Forest University Health Sciences
• Wake Forest University Health Sciences

• Clinical Medical Laboratory in High Point, NC
• Providers in High Point, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.