Wake Neurology PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

200400217 Issued in NC

Legal business name

WAKE NEUROLOGY PLLC

Practice address

1110 SE Cary Pkwy
Suite 206
Cary, NC 27518-7420

Phone

(919) 463-1101

Fax

(919) 463-1110

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kristy Driskell

Title

Office Administrator/Nurse

Phone

(919) 463-1101

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Virginia Ann Jethro, PA-C

  • Medical Physician Assistant
  • Raleigh, NC
  • NPI 1114988292
  NPD (past)
• Kelly Pate Nguyen, NP

  • Nurse Practitioner
  • Cary, NC
  • NPI 1801091343
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403827200000",
    "number": "1669547766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SE CARY PKWY",
            "address_2": "SUITE 206",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187420",
            "telephone_number": "919-463-1101",
            "fax_number": "919-463-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE CARY PKWY",
            "address_2": "SUITE 206",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187420",
            "telephone_number": "919-463-1101",
            "fax_number": "919-463-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE NEUROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2014-06-27",
        "status": "A",
        "authorized_official_last_name": "DRISKELL",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR/NURSE",
        "authorized_official_telephone_number": "919-463-1101",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "200400217",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NC",
            "license": "2423",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903406",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wake Endoscopy Center, LLC
• Wake Family Eye Care OD, PA
• Wake Family Eye Care OD, PA
• Wake Family Medicine PC
• Wake Heart and Vascular Associates P.a.
• Wake Neuropathy P.a.
• Wake OBGYN P.a.
• Wake Ophthalmology Associates, PA
• Wake Orthopaedics, LLC
• Wake Pediatric Speech Therapy

• Neurology Physician in Cary, NC
• Providers in Cary, NC by specialty
• Neurology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.