Active NPI
Matthew Wrench Sr., AGPCNP-C
- Gerontology Nurse Practitioner
- Fuquay Varina, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 5014776
- Practice address
- 2400 N Main St Ste 210
Fuquay Varina, NC 27526-8573 - Phone
- (919) 235-6501
- Fax
- (919) 341-3043
- NPI assigned
- Jul 27, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 5014776 | NC | |
| Gerontology Nurse Practitioner | 363LG0600X | 5014776 | NC | Primary |
Addresses
Primary practice location
2400 N Main St Ste 210
Fuquay Varina, NC 27526-8573
Mailing address
124 Teal Lake Dr
Holly Springs, NC 27540-8887
Phone (919) 369-2439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of North Carolina at Chapel Hill School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5014776 | NC | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raleigh Cardiology Associates, PA | Current | Accepting new patients | |
| Wakemed Specialists Group, LLC | Current | Accepting new patients | |
| Wakemed Specialists Group LLC | Current | Accepting new patients | |
| Wakemed Specialists Group, LLC | Current | Accepting new patients |
Locations
210 Ashville Ave
Cary, NC 27518
Phone (919) 235-6460
2400 N Main St
Ste 210
Fuquay Varina, NC 27526
Phone (919) 235-6501
3000 New Bern Ave
Ste 1200
Raleigh, NC 27610
Phone (919) 231-6132
3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1588227839
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1265488282
-
dba WakeMed - Virtual Cardiac Rehab
- Cardiac Rehabilitation Registered Nurse
- Raleigh, NC
- NPI 1063304228
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1104480532
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba WakeMed Mental Health & Well-Being Hospital WakeBrook
- Psychiatric Hospital Unit
- Raleigh, NC
- NPI 1780446302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1689347619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 TEAL LAKE DR",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275408887",
"telephone_number": "919-369-2439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 N MAIN ST STE 210",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275268573",
"telephone_number": "919-235-6501",
"fax_number": "919-341-3043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRENCH",
"first_name": "MATTHEW",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "AGPCNP-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-27",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NC",
"license": "5014776",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NC",
"license": "5014776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fuquay Varina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.