Wake Spine and Pain Specialists, PC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

WAKE SPINE AND PAIN SPECIALISTS, PC

Practice address

510 Timber Dr E Ste 105
Garner, NC 27529-4689

Phone

(919) 787-7246

Fax

(919) 787-7247

NPI assigned

Mar 2, 2017

Last updated

Jun 25, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

WAKE SPINE AND PAIN SPECIALISTS, PCAs reported in NPPES

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

Authorized official

Name

Bernadette Mauceri

Title

Office Manager

Phone

(919) 787-7246

Specialties & licenses 1

Addresses

Part of

Wake Spine and Pain Specialists PC

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.

• Wake Spine & Pain Specialists PC

  • Pain Medicine (Anesthesiology) Physician
  • Cary, NC
  • NPI 1568696748
  NPPES parent name

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1720528243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WAKE FOREST RD STE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096864",
            "telephone_number": "919-787-7246",
            "fax_number": "919-787-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 TIMBER DR E STE 105",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294689",
            "telephone_number": "919-787-7246",
            "fax_number": "919-787-7247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "958 Vandora Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Garner",
            "state": "NC",
            "postal_code": "275293544",
            "country_code": "US",
            "telephone_number": "919-787-7246",
            "fax_number": "919-787-7247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAKE SPINE AND PAIN SPECIALISTS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAKE SPINE AND PAIN SPECIALISTS, PC",
        "enumeration_date": "2017-03-02",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "MAUCERI",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "919-787-7246"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Garner, NC
• Providers in Garner, NC by specialty
• Pain Medicine (Anesthesiology) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.