Wake Endoscopy Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

ASO111 Issued in NC

Legal business name

WAKE ENDOSCOPY CENTER, LLC

Practice address

2601 Lake Dr
Suite 201
Raleigh, NC 27607-6688

Phone

(919) 783-4888

Fax

(919) 783-4887

NPI assigned

Dec 14, 2009

Organization subpart

No

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

Authorized official

Name

William Chance

Title

Administrator

Phone

(919) 783-4888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

Wake Endoscopy Center LLCCCN 34C0001165

Medicare certification status

ActiveFrom the Provider of Services file

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 4

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

• Andrea Brooks, FNP-C

  • Family Nurse Practitioner
  • Wilson, NC
  • NPI 1164842548
  NPD
• Eric Mannion, CRNA, RN

  • Certified Registered Nurse Anesthetist
  • Raleigh, NC
  • NPI 1093275869
  NPD
• Danielle Sharon Mernenko, CRNA

  • Certified Registered Nurse Anesthetist
  • Raleigh, NC
  • NPI 1033870068
  NPD
• Farah S. Hussain, M.D.

  • Gastroenterology Physician
  • Raleigh, NC
  • NPI 1265711444
  NPD (past)

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1497084982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 LAKE DR",
            "address_2": "SUITE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076688",
            "telephone_number": "919-783-4888",
            "fax_number": "919-783-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 LAKE DR",
            "address_2": "SUITE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076688",
            "telephone_number": "919-783-4888",
            "fax_number": "919-783-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-14",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "CHANCE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-783-4888"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "ASO111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wake Cross Roads Dentistry
• Wake Dermatology Associates, PA
• Wake Emergency Physicians PA
• Wake Emergency Physicians PA
• Wake Emergency Physicians PA
• Wake Enterprises Inc
• Wake Forest Counseling Associates, PLLC
• Wake Health Services
• Wake Health Services Inc.
• Wake Health Services, Inc

• All providers in Raleigh, NC
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.