NPIMap

Organization Active NPI

Raleigh Durham Medical Group, PA

Doing business as Western Wake Wellness

  • Family Medicine Physician
  • Cary, NC
National Provider Identifier
1316280415
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RALEIGH DURHAM MEDICAL GROUP, PA
Doing business as
Western Wake Wellness
Practice address
401 Keisler Dr
Suite 101
Cary, NC 27518-7084
Phone
(919) 378-1492
Fax
(919) 239-4670
NPI assigned
Mar 27, 2013
Last updated
Feb 5, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
RALEIGH DURHAM MEDICAL GROUP, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Authorized official

Name
David Moye
Title
Executive Director
Phone
(919) 851-2174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

401 Keisler Dr
Suite 101
Cary, NC 27518-7084

Mailing address

5420 Wade Park Blvd
Suite 106
Raleigh, NC 27607-4188
Phone (919) 233-5952

Other identifiers 1

IdentifierTypeStateIssuer
028FCOtherNCBCBS

Other names 1

  • Western Wake Wellness Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raleigh Durham Medical66 organizations share this tax ID, including this one
Part of
Raleigh Durham Medical

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

401 Keisler Dr
Ste 101
Cary, NC 27518
Phone (919) 378-1492

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1316280415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 WADE PARK BLVD",
            "address_2": "SUITE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276074188",
            "telephone_number": "919-233-5952",
            "fax_number": "919-854-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KEISLER DR",
            "address_2": "SUITE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187084",
            "telephone_number": "919-378-1492",
            "fax_number": "919-239-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH DURHAM MEDICAL GROUP, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RALEIGH DURHAM MEDICAL GROUP, PA",
        "enumeration_date": "2013-03-27",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "MOYE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-851-2174"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "028FC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Wake Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.