Wake Pet Services LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

WAKE PET SERVICES LLC

Practice address

210 Ashville Ave Ste 120
Cary, NC 27518-6601

Phone

(919) 350-8000

NPI assigned

Oct 20, 2020

Last updated

Nov 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Sessoms

Title

Executive VP, Finance & Cfo

Phone

(919) 350-0522

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

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

• Wakemed

  dba WakeMed Mental Health & Well-Being Hospital WakeBrook

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302

  Member Of

  NPD member

Locations

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Granville Alley Jr., M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
  • NPI 1417973298
  Medicare reassignment Care Compare group NPD
• Gregory Alexander Bortoff, M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
  • NPI 1295768596
  Medicare reassignment Care Compare group NPD
• Andrew Gregory Moran, M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
  • NPI 1437175239
  Medicare reassignment Care Compare group NPD
• Todd Jason Roth, M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
  • NPI 1558387365
  Medicare reassignment Care Compare group NPD
• Jerry Lynn Watson, M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
  • NPI 1497771216
  Medicare reassignment Care Compare group NPD
• Brian Luis Pando, MD

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1386105062

  NC

  Medicare reassignment Care Compare group
• Saiyyed Oomer Aziem, D.O.

  • Cardiovascular Disease Physician
  • Elkin, NC
  • NPI 1073662888
  Medicare reassignment NPD
• Jeffrey Robert Blackburn, MD

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1396928966
  Medicare reassignment NPD
• Inga Edwin, M.D.

  • Diagnostic Radiology Physician
  • Raleigh, NC
  • NPI 1679702658
  Medicare reassignment NPD
• Douglas Ian Friedman, MD

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1881986552
  Medicare reassignment NPD
• Brian M Go, M.D.

  • Interventional Cardiology Physician
  • Raleigh, NC
  • NPI 1851397152
  Medicare reassignment NPD
• Tapan Niranjan Godiwala, M.D.

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1649436536
  Medicare reassignment NPD

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1770182933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ASHEVILL AVENUE",
            "address_2": "SUITE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ASHVILLE AVE STE 120",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275186601",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE PET SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "SESSOMS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "EXECUTIVE VP, FINANCE & CFO",
        "authorized_official_telephone_number": "919-350-0522"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wake Neuropathy P.a. (Wake Chiropractic)
• Wake OBGYN P.a.
• Wake Ophthalmology Associates, PA
• Wake Orthopaedics, LLC
• Wake Pediatric Speech Therapy
• Wake Plastic Surgery, PLLC
• Wake Primary Care, PLLC
• Wake Psychological Associates PLLC
• Wake Specialty Physicians (WSP-Wake Orthopaedics)
• Wake Specialty Physicians (WSP Wellness Family Practice)

• Diagnostic Radiology Physician in Cary, NC
• Providers in Cary, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.