NPIMap

Organization Active NPI

Wake Health Services, Inc

Doing business as Oberlin Outreach Center

  • Federally Qualified Health Center (FQHC)
  • Raleigh, NC
National Provider Identifier
1255574331
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WAKE HEALTH SERVICES, INC
Doing business as
Oberlin Outreach Center
Practice address
1012 Oberlin Rd
Raleigh, NC 27605-1135
Phone
(919) 833-3111
Fax
(919) 250-2949
NPI assigned
Apr 20, 2009
Last updated
Apr 20, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
WAKE HEALTH SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Authorized official

Name
Ms. Jacqueline Morlando
Title
Cfo
Phone
(919) 250-2939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1012 Oberlin Rd
Raleigh, NC 27605-1135

Mailing address

2620 New Bern Ave
Raleigh, NC 27610-1821
Phone (919) 250-2944

Other names 1

  • OBERLIN OUTREACH CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040824000695 NC Part B Supplier - Clinic/Group Practice 3577471697 Receives reassigned benefits from 91 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wendell, NC; Wake Forest, NC; Raleigh, NC; Louisburg, NC; Apex, NC; Cary, NC; Holly Springs, NC; Fuquay Varina, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255574331. Details of each certification follow.

  • CCN 341944 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 341944

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
OBERLIN OUTREACH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 26, 2009
Last certification
Jun 26, 2009
Ownership / control type
For profit – corporation
Facility address
1012 Oberlin Road
Raleigh, NC 27605

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Part of
Wake Health Services in

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1255574331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101821",
            "telephone_number": "919-250-2944",
            "fax_number": "919-250-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 OBERLIN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051135",
            "telephone_number": "919-833-3111",
            "fax_number": "919-250-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE HEALTH SERVICES, INC",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "MORLANDO",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-250-2939",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OBERLIN OUTREACH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.