Wayne Health Medical Clinic, LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

WAYNE HEALTH MEDICAL CLINIC, LLC

Practice address

208 Cox Blvd
Suite 102
Goldsboro, NC 27534-9414

Phone

(919) 587-4081

Fax

(919) 587-0775

NPI assigned

Dec 19, 2011

Organization subpart

Yes

Parent organization

WAYNE HEALTH PHYSICIANSAs reported in NPPES

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

Authorized official

Name

Clyde Louis Thomas

Title

Executive Director

Phone

(919) 587-4081

Specialties & licenses 1

Addresses

Part of

Wayne Health Physicians

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wayne Health Physicians

  dba Wayne Health Psychiatric Services

  • Clinical Social Worker
  • Goldsboro, NC
  • NPI 1053661066
  NPPES parent name

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1558630699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1717",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275331717",
            "telephone_number": "919-587-4081",
            "fax_number": "919-587-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COX BLVD",
            "address_2": "SUITE 102",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349414",
            "telephone_number": "919-587-4081",
            "fax_number": "919-587-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE HEALTH MEDICAL CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNE HEALTH PHYSICIANS",
        "enumeration_date": "2011-12-19",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-587-4081"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Dermatology and Cosmetic Surgery PA
• Wayne Family Medical Center, Inc.
• Wayne Foot Specialists PC
• Wayne Health Family Medicine LLC
• Wayne Health Foundation (Watch)
• Wayne Health Physicians (Wayne Health Psychiatric Services)
• Wayne Health Physicians
• Wayne Health Surgical Associates
• Wayne Health Urological Associates LLC
• Wayne Health Vascular and Vein Center LLC

• Endocrinology, Diabetes & Metabolism Physician in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Endocrinology, Diabetes & Metabolism Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.