Wake Spine and Pain Specialists, PC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

WAKE SPINE AND PAIN SPECIALISTS, PC

Practice address

1357 Walter Reed Rd Ste 101
Fayetteville, NC 28304-4417

Phone

(919) 787-7246

Fax

(919) 787-7247

NPI assigned

Jan 12, 2021

Organization subpart

Yes

Parent organization

WAKE SPINE AND PAIN SPECIALISTS, PCAs reported in NPPES

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

Authorized official

Name

Vijaysinha Mandhare, MD

Title

Medical Director

Phone

(919) 787-7246

Specialties & licenses 1

Addresses

Part of

Wake Spine Pain Specialist

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wake Spine & Pain Specialists PC

  • Pain Medicine (Anesthesiology) Physician
  • Cary, NC
  • NPI 1568696748
  NPPES parent name

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1336738632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WAKE FOREST RD STE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096864",
            "telephone_number": "919-787-7246",
            "fax_number": "919-787-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 WALTER REED RD STE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044417",
            "telephone_number": "919-787-7246",
            "fax_number": "919-787-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE SPINE AND PAIN SPECIALISTS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE SPINE AND PAIN SPECIALISTS, PC",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "MANDHARE",
        "authorized_official_first_name": "VIJAYSINHA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "919-787-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fayetteville, NC
• Pain Medicine (Anesthesiology) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.