Wakelon Internal Medicine PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200001025 Issued in NC

Legal business name

WAKELON INTERNAL MEDICINE PLLC

Practice address

301 Hospital Road
Zebulon, NC 27597

Phone

(919) 269-0390

Fax

(919) 269-6868

NPI assigned

Nov 14, 2006

Last updated

Sep 4, 2007By 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

Ms. Shelly Lorraine West, MD

Title

MD

Phone

(919) 269-0390

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1861564924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL ROAD",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "27597",
            "telephone_number": "919-269-0390",
            "fax_number": "919-269-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL ROAD",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "27597",
            "telephone_number": "919-269-0390",
            "fax_number": "919-269-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKELON INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "919-269-0390",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200001025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7632748",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "127GV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2022572",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89127GV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2077334",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00255758",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Zebulon, NC
• Providers in Zebulon, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.