Active NPI
Wake Forest Health Network LLC
- Family Medicine Physician
- Summerfield, NC
National Provider Identifier
1730416801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WAKE FOREST HEALTH NETWORK LLC
- Practice address
- 4431 Hwy 220 N
Summerfield, NC 27358-9411 - Phone
- (336) 643-7711
- Fax
- (336) 643-3047
- NPI assigned
- Nov 11, 2009
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
4431 Hwy 220 N
Summerfield, NC 27358-9411
Mailing address
4431 US Highway 220 N
Summerfield, NC 27358-9411
Phone (336) 643-7711
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5913764 | Medicaid | NC | |
| DP8978 | Other | NC | RR MEDICARE |
Other names 1
- Atrium Health Wake Forest Baptist Family Medicine - Summerfield
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Community/Retail Pharmacy
- Winston Salem, NC
- NPI 1881460855
Member Of
Locations
4515 Premier Dr
Ste 401
High Point, NC 27265
Phone (336) 802-2240
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Summerfield, NC
- NPI 1831918796
-
- Family Medicine Physician
- Chapel Hill, NC
- NPI 1700204419
-
- Family Medicine Physician
- Summerfield, NC
- NPI 1982993309
-
- Registered Dietitian
- High Point, NC
- NPI 1578860375
-
- Nurse Practitioner
- Winston Salem, NC
- NPI 1871942219
-
- Nurse Practitioner
- Summerfield, NC
- NPI 1881384485
-
- Physician Assistant
- Moultrie, GA
- NPI 1114505674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758758400000",
"number": "1730416801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4431 US HIGHWAY 220 N",
"city": "SUMMERFIELD",
"state": "NC",
"postal_code": "273589411",
"telephone_number": "336-643-7711",
"fax_number": "336-643-3047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4431 HWY 220 N",
"city": "SUMMERFIELD",
"state": "NC",
"postal_code": "273589411",
"telephone_number": "336-643-7711",
"fax_number": "336-643-3047"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAKE FOREST HEALTH NETWORK LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-11-11",
"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": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5913764",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "DP8978",
"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 - Summerfield",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Summerfield, 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.