NPIMap

Organization Active NPI

Wake Forest Health Network LLC

  • Internal Medicine Physician
  • Kernersville, NC
National Provider Identifier
1922434307
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WAKE FOREST HEALTH NETWORK LLC
Practice address
861 Old Winston Rd
Suite 101
Kernersville, NC 27284-7140
Phone
(336) 904-0043
Fax
(336) 904-0046
NPI assigned
Sep 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

861 Old Winston Rd
Suite 101
Kernersville, NC 27284-7140

Mailing address

861 Old Winston Rd Ste 101
Kernersville, NC 27284-7141
Phone (336) 904-0043

Other names 2

  • Atrium Health Wake Forest Baptist Internal Medicine - Kernersville Doing business as
  • Atrium Health Wake Forest Baptist Primary Care - Kernersville Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
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

Enrollment IDStateProvider typePAC IDDetails
O20031117000868 NC Part B Supplier - Clinic/Group Practice 4183538895 Receives reassigned benefits from 690 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: High Point, NC; Jefferson, NC; Jonesville, NC; Kernersville, NC; Summerfield, NC; Thomasville, NC; Winston Salem, NC; Archdale, NC…

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1701 Westchester Dr
Ste 8502
High Point, NC 27262

861 Old Winston Rd
Ste 101
Kernersville, NC 27284
Phone (336) 904-0043

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1922434307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 OLD WINSTON RD STE 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847141",
            "telephone_number": "336-904-0043",
            "fax_number": "336-904-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 OLD WINSTON RD",
            "address_2": "SUITE 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847140",
            "telephone_number": "336-904-0043",
            "fax_number": "336-904-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE FOREST HEALTH NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-18",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Internal Medicine - Kernersville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atrium Health Wake Forest Baptist Primary Care - Kernersville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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.

Verify at the official NPI Registry.