Wakefield Medical Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

00838 Issued in NC

Legal business name

WAKEFIELD MEDICAL INC

Practice address

123 Capcom Ave Ste 3
Wake Forest, NC 27587-6517

Phone

(919) 570-5277

Fax

(919) 570-5377

NPI assigned

Sep 26, 2006

Last updated

Aug 22, 2020By 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

Mr. Kevin Brian Shearin

Title

President

Phone

(919) 570-5277

Specialties & licenses 1

Addresses

Other identifiers 2

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

CLIA laboratory certificates

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942301601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 CAPCOM AVE STE 3",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876517",
            "telephone_number": "919-570-5277",
            "fax_number": "919-570-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 CAPCOM AVE STE 3",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876517",
            "telephone_number": "919-570-5277",
            "fax_number": "919-570-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEFIELD MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEARIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-570-5277",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "00838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7703955",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "046XY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wake Specialty Physicians (WakeMed MyCare 365 Primary & Urgent Care Wake Forest)
• Wake Specialty Physicians LLC (WakeMed Primary Care Wake Forest)
• Wake Specialty Physicians LLC (WakeMed MyCare 365 Primary & Urgent Care Wake Forest)
• Wake Specialty Physicians LLC (WakeMed Children's - Pediatrics Wake Forest)
• Wakefield Eye Care, OD PLLC
• Wakefield Medical Specialty Services Inc
• Wakemed Specialists Group LLC (WakeMed Wake Orthopaedics)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5254)
• Wal-Mart Stores East, LP (Vision Center 30-5254)
• Walgreen Co (Rite Aid)

• Durable Medical Equipment & Medical Supplies in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.