NPIMap

Organization Active NPI

Wfubmccp Primary Care, LLC

Doing business as Wake Forest Baptist Healthcare Center - Davie

  • Primary Care Clinic/Center
  • Mocksville, NC
National Provider Identifier
1407007131
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WFUBMCCP PRIMARY CARE, LLC
Doing business as
Wake Forest Baptist Healthcare Center - Davie
Practice address
1188 Yadkinville Rd
Mocksville, NC 27028-2037
Phone
(336) 751-8304
Fax
(336) 751-8402
NPI assigned
Sep 30, 2008
Last updated
Sep 30, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH CAROLINA BAPTIST HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Authorized official

Name
Mr. McLain Wallace Jr.
Title
General Counsel
Phone
(336) 716-2817

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1188 Yadkinville Rd
Mocksville, NC 27028-2037

Mailing address

PO Box 1209
Mocksville, NC 27028-1209
Phone (336) 751-8304

Other names 1

  • Wake Forest Baptist Healthcare Center - Davie Doing business as

National Provider Directory

National Provider Directory
Part of
North Carolina Baptist H

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1188 Yadkinville Rd
Mocksville, NC 27028
Phone (336) 716-7435

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1407007131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270281209",
            "telephone_number": "336-751-8304",
            "fax_number": "336-751-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 YADKINVILLE RD",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282037",
            "telephone_number": "336-751-8304",
            "fax_number": "336-751-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WFUBMCCP PRIMARY CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH CAROLINA BAPTIST HOSPITAL",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MCLAIN",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "336-716-2817",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wake Forest Baptist Healthcare Center - Davie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mocksville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.