NPIMap

Organization Active NPI

Wakemed Specialists Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Raleigh, NC
National Provider Identifier
1093370389
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
WAKEMED SPECIALISTS GROUP, LLC
Practice address
10010 Falls of Neuse Rd Ste 11
Raleigh, NC 27614-8495
Phone
(919) 232-5020
Fax
(919) 235-0610
NPI assigned
May 2, 2019
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Maria Jayoussi
Title
Executive Director of Finance
Phone
(919) 350-6089

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 35

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

View all 35

Member of 1

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

Practitioners 868

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

View all 868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20190903001082 NC DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2466788377 Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory
Tax ID family
Wakemed Specialists Group LLC (36 organizations share this tax ID)

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

10010 Falls of Neuse Rd Ste 11
Raleigh, NC 27614-8495

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0552

Other names 1

NPPES NPI Registry
  • WakeMed Wake Orthopaedics Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2019.

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564617600000",
    "number": "1093370389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "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": "10010 FALLS OF NEUSE RD STE 11",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148495",
            "telephone_number": "919-232-5020",
            "fax_number": "919-235-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEMED SPECIALISTS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-08-01",
        "status": "A",
        "authorized_official_last_name": "JAYOUSSI",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "919-350-6089"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WakeMed Wake Orthopaedics",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WakeMed Wake Orthopaedics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 1, 2019; 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.