Wake Forest Health Network LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WAKE FOREST HEALTH NETWORK LLC

Practice address

305 1St St E
Conover, NC 28613-1715

Phone

(828) 464-3821

Fax

(828) 464-8994

NPI assigned

Mar 19, 2012

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, MD

Title

Sr VP Clinical Operations

Phone

(336) 716-1331

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Atrium Health Wake Forest Baptist Family Medicine - Conover 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

Locations

Practitioners 8

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

• David Coffey, M.D.

  • Family Medicine Physician
  • Conover, NC
  • NPI 1740269638
  NPD
• Michael Wayne Evans, M.D.

  • Ophthalmology Physician
  • High Point, NC
  • NPI 1346569548
  NPD
• Steven Houston, DO

  • Family Medicine Physician
  • Conover, NC
  • NPI 1811420086
  NPD
• William Long, M.D.

  • Family Medicine Physician
  • Conover, NC
  • NPI 1346229002
  NPD
• Alyssa Ann Mallard, DNP/FNP

  • Nurse Practitioner
  • Conover, NC
  • NPI 1639971823
  NPD
• Rebecca Keener McKinnon, M.D.

  • Family Medicine Physician
  • Yadkinville, NC
  • NPI 1548587983
  NPD
• Brian S Vierling, MD

  • Family Medicine Physician
  • Conover, NC
  • NPI 1750360566
  NPD
• Shambo Guha Roy, MD

  • Student in an Organized Health Care Education/Training Program
  • Darby, PA
  • NPI 1376029926
  NPD

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1326313735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 1ST ST E",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286131715",
            "telephone_number": "828-464-3821",
            "fax_number": "828-464-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 1ST ST E",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286131715",
            "telephone_number": "828-464-3821",
            "fax_number": "828-464-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST HEALTH NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "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",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920103",
            "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 Family Medicine - Conover",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian S Vierling, MD
• James D Vinson, DDS
• Voca Corporation of North Carolina
• Voca Corporation of North Carolina
• Voca Corporation of North Carolina
• Wake Forest University Health Sciences
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Walk With Me

• Family Medicine Physician in Conover, NC
• Providers in Conover, 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.