NPIMap

Organization Active NPI

Wake Specialty Physicians LLC

Doing business as WakeMed MyCare 365 Primary & Urgent Care Brightleaf

  • Family Medicine Physician
  • Smithfield, NC
National Provider Identifier
1922879246
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WAKE SPECIALTY PHYSICIANS LLC
Doing business as
WakeMed MyCare 365 Primary & Urgent Care Brightleaf
Practice address
938 N Brightleaf Blvd
Smithfield, NC 27577-4331
Phone
(919) 350-8000
NPI assigned
Jan 15, 2024
Last updated
Jan 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Authorized official

Name
Michael Paul Duffey
Title
Executive Director Finance
Phone
(919) 350-8000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

938 N Brightleaf Blvd
Smithfield, NC 27577-4331

Mailing address

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

Other names 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090601000520 NC Part B Supplier - Clinic/Group Practice 7416006085 Receives reassigned benefits from 283 practitioners
43 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 43

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

View all 43

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2297746Wakemed Mycare 365 Primary & Urgent Care-938 N. Brightleaf Blvd, Smithfield, NC 27577Certificate of waiverJan 21, 2028

National Provider Directory

National Provider Directory

Locations

938 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 235-1525

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1922879246",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 N BRIGHTLEAF BLVD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774331",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE SPECIALTY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "DUFFEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR FINANCE",
        "authorized_official_telephone_number": "919-350-8000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WakeMed MyCare 365 Primary & Urgent Care Brightleaf",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.