NPIMap

Organization Active NPI

Wake Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Raleigh, NC
National Provider Identifier
1326034208
Registry record updated Aug 22, 2020
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
Practice address
102 N Tarboro Rd
Raleigh, NC 27610-2352
Phone
(919) 743-3315
Fax
(919) 743-0580
NPI assigned
Sep 26, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jackie Morlando
Title
Chief Finiancial Officer
Phone
(919) 250-2939

Specialties & licenses 1

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

Addresses

Primary practice location

102 N Tarboro Rd
Raleigh, NC 27610-2352

Mailing address

102 N Tarboro Rd
Raleigh, NC 27610-2352
Phone (919) 743-3315

Other identifiers 1

IdentifierTypeStateIssuer
344589AMedicaidNC

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 1326034208. Details of each certification follow.

  • CCN 341869 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 341869

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
HORIZON HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 27, 2003
Last certification
Jun 27, 2003
Ownership / control type
For profit – corporation
Facility address
102 North Tarboro Road
Raleigh, NC 27610

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

Locations

1001 Rock Quarry Rd
Raleigh, NC 27610
Phone (919) 250-2934

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326034208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N TARBORO RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102352",
            "telephone_number": "919-743-3315",
            "fax_number": "919-743-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N TARBORO RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102352",
            "telephone_number": "919-743-3315",
            "fax_number": "919-743-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORLANDO",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CHIEF FINIANCIAL OFFICER",
        "authorized_official_telephone_number": "919-250-2939",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344589A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.