NPIMap

Organization Active NPI

Wake Specialty Physicians LLC

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1881269801
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WAKE SPECIALTY PHYSICIANS LLC
Practice address
3001 Calumet Dr
Raleigh, NC 27610-1901
Phone
(919) 350-0365
Fax
(919) 235-1307
NPI assigned
May 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

3001 Calumet Dr
Raleigh, NC 27610-1901

Mailing address

PO Box 602195
Charlotte, NC 28260-2195
Phone (919) 350-0554

Other names 1

  • WakeMed MyCare 365 Primary & Urgent Care Sunnybrook Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Falls Pointe Medical Group70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Locations

3001 Calumet Dr
Raleigh, NC 27610

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1881269801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0554",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 CALUMET DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101901",
            "telephone_number": "919-350-0365",
            "fax_number": "919-235-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE SPECIALTY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "SHONDRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP, WPP OPERATIONS",
        "authorized_official_telephone_number": "919-350-6045"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WakeMed MyCare 365 Primary & Urgent Care Sunnybrook",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.