NPIMap

Wakemed Specialists Group, LLC

Organization Active NPI Psychiatry Physician · Raleigh, NC

NPI 1194389643 · NPPES record last updated Apr 30, 2019

Key facts

NPI
1194389643
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatry Physician 2084P0800X
Legal business name
WAKEMED SPECIALISTS GROUP, LLC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-8000
NPI assigned
Apr 30, 2019
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 47

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 47

Practitioners 54

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

View all 54

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190731000815 NC Part B Supplier - Clinic/Group Practice 2466788377 Receives reassigned benefits from 1,327 practitioners
47 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Locations

111 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 216-2955

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X Yes

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (919) 350-0554

Other names

  • WakeMed Psychiatry Other name

Other providers in Raleigh, NC

All providers in Raleigh, NC · Psychiatry Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.