NPIMap

Organization Active NPI

Wake Forest Health Network, LLC

  • Family Medicine Physician
  • High Point, NC
National Provider Identifier
1700901436
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WAKE FOREST HEALTH NETWORK, LLC
Practice address
4515 Premier Dr
Suite 201
High Point, NC 27265-8357
Phone
(336) 802-2610
Fax
(336) 802-2611
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Craig Michael Greven, MD
Title
Sr VP Clinical Operations
Phone
(336) 716-1331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4515 Premier Dr
Suite 201
High Point, NC 27265-8357

Mailing address

4515 Premier Dr Ste 201
High Point, NC 27265-8356
Phone (336) 802-2610

Other identifiers 11

IdentifierTypeStateIssuer
CC4241OtherNCRR MEDICARE
269374OtherNCMAMSI
0246KOtherNCBCBS
D266OtherNCPARTNERS MEDICARE CHOICE
1212660012OtherNCDME
890246KMedicaidNC
7446746OtherNCAETNA
CB8658OtherNCRRMC GROUP
CC4243OtherNCRR MEDICARE
CD6614OtherNCRR MEDICARE
50132OtherNCMEDCOST

Other names 1

  • Atrium Health Wake Forest Baptist Family Medicine - Premier Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000868 NC Part B Supplier - Clinic/Group Practice 4183538895 Receives reassigned benefits from 690 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: High Point, NC; Jefferson, NC; Jonesville, NC; Kernersville, NC; Summerfield, NC; Thomasville, NC; Winston Salem, NC; Archdale, NC…

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4515 Premier Dr
Ste 204
High Point, NC 27265
Phone (336) 802-2015

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1700901436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DR STE 201",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658356",
            "telephone_number": "336-802-2610",
            "fax_number": "336-802-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DR",
            "address_2": "SUITE 201",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658357",
            "telephone_number": "336-802-2610",
            "fax_number": "336-802-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST HEALTH NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "GREVEN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SR VP CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "336-716-1331",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC4241",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "269374",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0246K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "D266",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "1212660012",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890246K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7446746",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC GROUP",
            "identifier": "CB8658",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC4243",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CD6614",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "50132",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Wake Forest Baptist Family Medicine - Premier",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.