Wake Forest Health Network LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WAKE FOREST HEALTH NETWORK LLC

Practice address

905 Phillips Ave
High Point, NC 27262-7075

Phone

(336) 802-2040

Fax

(336) 802-2041

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Craig Michael Greven

Title

Sr VP Clinical Operations

Phone

(336) 716-1331

Specialties & licenses 2

Addresses

Other identifiers 14

Other names 1

• Atrium Health Wake Forest Baptist High Point Family Medicine Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

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

• North Carolina Baptist Hospital

  • Community/Retail Pharmacy
  • Winston Salem, NC
  • NPI 1881460855

  Member Of

  NPD member

Practitioners 13

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

• Akira Lanese Barhams, M.D.

  • Family Medicine Physician
  • High Point, NC
  • NPI 1043416118
  NPD
• David M. Haimes, MD

  • Family Medicine Physician
  • High Point, NC
  • NPI 1578583738
  NPD
• Tyesha Brookes Jackson, NP

  • Nurse Practitioner
  • High Point, NC
  • NPI 1194480962
  NPD
• Justin Roger Judd, DO

  • Family Medicine Physician
  • High Point, NC
  • NPI 1316528235
  NPD
• James Sloan Manning, MD

  • Family Medicine Physician
  • High Point, NC
  • NPI 1952364259
  NPD
• John Christopher McFadden, MD

  • Family Medicine Physician
  • High Point, NC
  • NPI 1770503930
  NPD
• Mariah Renee Mosier, PA-C

  • Physician Assistant
  • High Point, NC
  • NPI 1538029848
  NPD
• Benjamin Keith Roddy, MSN FNP

  • Nurse Practitioner
  • High Point, NC
  • NPI 1629801881
  NPD
• Le'Starr Monique Rose, FNP

  • Nurse Practitioner
  • Greensboro, NC
  • NPI 1619391109
  NPD
• William Thomas Smith, M.D.

  • Internal Medicine Physician
  • Winston Salem, NC
  • NPI 1558320523
  NPD
• Heather M Spry, MD

  • Family Medicine Physician
  • High Point, NC
  • NPI 1154432862
  NPD
• John W. Weaver, MD

  • Family Medicine Physician
  • High Point, NC
  • NPI 1154341311
  NPD

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1275658692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 PHILLIPS AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627075",
            "telephone_number": "336-802-2040",
            "fax_number": "336-802-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 PHILLIPS AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627075",
            "telephone_number": "336-802-2040",
            "fax_number": "336-802-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST HEALTH NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "GREVEN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SR VP CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "336-716-1331"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "D266",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "269374",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC6608",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC4242",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "80024",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC4243",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890246W",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CD6614",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC4241",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7338741",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC5472",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0246W",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "CB8658",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CF9200",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Wake Forest Baptist High Point Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wake Forest Health Network LLC
• Wake Forest Health Network LLC
• Wake Forest Health Network LLC
• Wake Forest Health Network LLC
• Wake Forest Health Network LLC
• Wake Forest Health Network LLC
• Wake Forest Health Network LLC
• Wake Forest Health Network LLC
• Wake Forest Health Network LLC
• Wake Forest Health Network LLC

• Family Medicine Physician in High Point, NC
• Providers in High Point, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.