Organization Active NPI

North Wake Pediatrics

  • Pediatrics Physician
  • Raleigh, NC
National Provider Identifier
1477378669
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORTH WAKE PEDIATRICS
Practice address
701 Exposition PL Ste 202
Raleigh, NC 27615-3359
Phone
(919) 848-2167
Fax
(919) 848-2168
NPI assigned
Nov 21, 2024
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Janet Woodall
Title
Credentialing Manager
Phone
(336) 932-3506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

701 Exposition PL Ste 202
Raleigh, NC 27615-3359

Mailing address

PO Box 12160
Belfast, ME 04915-4012
Phone (919) 848-2167

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1070997North Wake Pediatrics701 Exposition Place, Suite 202, Raleigh, NC 27615Certificate of waiverAug 21, 2026

National Provider Directory

National Provider Directory

Locations

701 Exposition Pl
Ste 202
Raleigh, NC 27615
Phone (919) 848-2167

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6973/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1477378669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12160",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154012",
            "telephone_number": "919-848-2167",
            "fax_number": "919-848-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 EXPOSITION PL STE 202",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153359",
            "telephone_number": "919-848-2167",
            "fax_number": "919-848-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH WAKE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "WOODALL",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "336-932-3506"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.