NPIMap

Organization Active NPI

Wake Forest Baptist Health

  • Primary Care Clinic/Center
  • Lewisville, NC
National Provider Identifier
1093198616
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
001005813 Issued in NC
Legal business name
WAKE FOREST BAPTIST HEALTH
Practice address
6630 Shallowford Rd
Lewisville, NC 27023-9504
Phone
(336) 716-9253
NPI assigned
Jun 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Robin Allison
Title
Provider Relations Coordinator
Phone
(336) 721-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 001005813 NC Primary

Addresses

Primary practice location

6630 Shallowford Rd
Lewisville, NC 27023-9504

Mailing address

6630 Shallowford Rd
Lewisville, NC 27023-9504
Phone (336) 716-9253

National Provider Directory

National Provider Directory
Tax ID family
Wake Forest Baptist Health4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1093198616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 SHALLOWFORD RD",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270239504",
            "telephone_number": "336-716-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 SHALLOWFORD RD",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270239504",
            "telephone_number": "336-716-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST BAPTIST HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "PROVIDER RELATIONS COORDINATOR",
        "authorized_official_telephone_number": "336-721-3937"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "001005813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.