NPIMap

Wakemed Specialists Group LLC

Organization Active NPI Plastic and Reconstructive Surgery Physician · Raleigh, NC

NPI 1821736075 · NPPES record last updated May 26, 2022

Key facts

NPI
1821736075
Entity type
Organization (NPI type 2)
Primary specialty
Plastic and Reconstructive Surgery Physician 2086S0122X
Legal business name
WAKEMED SPECIALISTS GROUP LLC
Practice address
3024 New Bern Ave
Raleigh, NC 27610-1247
Phone
(919) 350-7331
NPI assigned
May 26, 2022
Organization subpart
No

Authorized official

Name
Shondra Lynn Brink
Title
VP, WPP
Phone
(919) 350-6045

Other NPIs on the same Medicare enrollment 47

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 47

Practitioners 17

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190731000815 NC Part B Supplier - Clinic/Group Practice 2466788377 Receives reassigned benefits from 1,327 practitioners
47 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X
Plastic and Reconstructive Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0122X Yes

Addresses

Primary practice location

3024 New Bern Ave
Raleigh, NC 27610-1247

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0554

Other names

  • WakeMed Plastic & Reconstructive Surgery Doing business as

Other providers in Raleigh, NC

All providers in Raleigh, NC · Plastic and Reconstructive Surgery Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.