Southern Wake Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTHERN WAKE MEDICAL CENTER

Practice address

415 Wake Chapel Rd
Fuquay Varina, NC 27526-1956

Phone

(919) 552-9143

NPI assigned

Dec 21, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Donna M Yowell

Title

Office Administrator

Phone

(919) 557-4319

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568526812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409-415 WAKE CHAPEL RD",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "27526",
            "telephone_number": "919-552-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 WAKE CHAPEL RD",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261956",
            "telephone_number": "919-552-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN WAKE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOWELL",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "919-557-4319",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902981",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER BCBSNC",
            "identifier": "02981",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soul Care Psychiatry PLLC
• South Wake Oral Surgery & Dental Implants
• Southern Cross Community Service Inc.
• Southern Cross Community Services Inc (Southern Cross Mental Health Centers)
• Southern Wake Counseling Center
• Gina Marie Sox, RDH
• Wanet Elizabeth Sparks, NP
• Speak Easy Rehabilitation, PLLC
• Drew Parker Spears, FNP
• Sharon Y Speed, M.D.

• Family Medicine Physician in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.