Wakemed Specialists Group, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WAKEMED SPECIALISTS GROUP, LLC

Practice address

110 Kildaire Park Dr Ste 101
Cary, NC 27518-8162

Phone

(919) 859-1136

Fax

(919) 859-4240

NPI assigned

May 6, 2019

Last updated

Apr 19, 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

Shondra Lynn Brink

Title

VP, WPP Operations

Phone

(919) 350-6045

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WakeMed Urgent Care Other name

Member of 1

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

• Wakemed

  dba WakeMed Mental Health & Well-Being Hospital WakeBrook

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302

  Member Of

  NPD member

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1184289159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "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": "110 KILDAIRE PARK DR STE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188162",
            "telephone_number": "919-859-1136",
            "fax_number": "919-859-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEMED SPECIALISTS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "SHONDRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP, WPP OPERATIONS",
        "authorized_official_telephone_number": "919-350-6045"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386209633",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WakeMed Urgent Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WakeMed Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wakemed Specialists Group LLC
• Wakemed Specialists Group LLC (WakeMed Heart & Vascular - Cary Cardiology)
• Wakemed Specialists Group LLC (WakeMed Cary Cardiology)
• Wakemed Specialists Group, LLC
• Wakemed Specialists Group, LLC
• Wakemed Specialists Group, LLC (WakeMed Sleep Medicine)
• Wakemed Surgery Center - Cary LLC
• Wal Mart
• Wal-Mart Neighborhood Market
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2414)

• Durable Medical Equipment & Medical Supplies in Cary, NC
• Providers in Cary, 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 Apr 19, 2021; 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.