Wake Specialty Physicians LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WAKE SPECIALTY PHYSICIANS LLC

Doing business as

WakeMed Wake Orthopaedics

Practice address

400 US Highway 70 East
Suite 202
Garner, NC 27529-4049

Phone

(919) 232-5020

Fax

(919) 232-5021

NPI assigned

Sep 17, 2015

Last updated

Dec 31, 2015By 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

Maria Jayoussi

Title

Executive Director Finance

Phone

(919) 350-6089

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• WakeMed Wake Orthopaedics Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Wakemed

  dba Wakemed Cary Hospital

  • General Acute Care Hospital
  • Cary, NC
  • NPI 1114993086

  Member Of

  NPD member

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451520000000",
    "number": "1093184368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "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": "400 US HIGHWAY 70 EAST",
            "address_2": "SUITE 202",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294049",
            "telephone_number": "919-232-5020",
            "fax_number": "919-232-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE SPECIALTY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-12-31",
        "status": "A",
        "authorized_official_last_name": "JAYOUSSI",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR FINANCE",
        "authorized_official_telephone_number": "919-350-6089"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN",
            "identifier": "7108950004",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942440375",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WakeMed Wake Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Telia Yevette Virgin, L.C.S.W.
• Olivia Faye Vogel, PMHNP-BC
• Volta Group International (Volta Express International)
• Gia Vu
• Wake Emergency Physicians PA
• Wake Specialty Physicians LLC (WakeMed Primary Care Garner)
• Wake Specialty Physicians LLC (WakeMed MyCare 365 Primary & Urgent Care Middle Creek)
• Wake Spine and Pain Specialists, PC
• Wake Urgent Care & Family Clinic Inc.
• Wakemed Specialists Group, LLC (WakeMed Urgent Care)

• Durable Medical Equipment & Medical Supplies in Garner, NC
• Providers in Garner, NC by specialty
• 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 Dec 31, 2015; 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.