NPIMap

Organization Active NPI

Wakemed Specialists Group LLC

  • Urgent Care Clinic/Center
  • Fuquay Varina, NC
National Provider Identifier
1376118398
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
WAKEMED SPECIALISTS GROUP LLC
Practice address
231 N Judd Pkwy NE
Fuquay Varina, NC 27526-2694
Phone
(919) 235-6560
Fax
(919) 235-6597
NPI assigned
May 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Authorized official

Name
Shondra Lynn Brink
Title
VP, WPP Operations
Phone
(919) 350-6045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

231 N Judd Pkwy NE
Fuquay Varina, NC 27526-2694

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0554

Other names 1

  • WakeMed Virtual Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wakemed Specialists Group LLC36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1376118398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "919-350-0554",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N JUDD PKWY NE",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262694",
            "telephone_number": "919-235-6560",
            "fax_number": "919-235-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEMED SPECIALISTS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "SHONDRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP, WPP OPERATIONS",
        "authorized_official_telephone_number": "919-350-6045"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WakeMed Virtual Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.