NPIMap

Organization Active NPI

Wake Health Services

Doing business as Rock Quarry Road Family Medicine

  • Non-Pharmacy Dispensing Site
  • Raleigh, NC
National Provider Identifier
1497992549
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
200301233 Issued in NC
Legal business name
WAKE HEALTH SERVICES
Doing business as
Rock Quarry Road Family Medicine
Practice address
1001 Rock Quarry Rd
Raleigh, NC 27610-3825
Phone
(919) 755-5071
NPI assigned
Jan 12, 2009
Last updated
Jan 12, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 200301233 NC Primary

Addresses

Primary practice location

1001 Rock Quarry Rd
Raleigh, NC 27610-3825

Mailing address

5810 Nancy Ridge Dr
100
San Diego, CA 92121-2834

Other names 1

  • Rock Quarry Road Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wake Health Services17 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1497992549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 NANCY RIDGE DR",
            "address_2": "100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ROCK QUARRY RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103825",
            "telephone_number": "919-755-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NC",
            "license": "200301233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rock Quarry Road Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 12, 2009; 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.