NPIMap

Organization Active NPI

Wake Health Services Inc.

Doing business as Advance Community Health

  • Federally Qualified Health Center (FQHC)
  • Raleigh, NC
National Provider Identifier
1992979934
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WAKE HEALTH SERVICES INC.
Doing business as
Advance Community Health
Practice address
1420 N Wilmington St
Raleigh, NC 27603-2526
Phone
(919) 250-2930
Fax
(919) 573-4734
NPI assigned
Apr 22, 2008
Last updated
Jan 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Authorized official

Name
Penella M Washington
Title
Ceo
Phone
(919) 250-2923

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Federally Qualified Health Center (FQHC) 261QF0400X NC Primary

Addresses

Primary practice location

1420 N Wilmington St
Raleigh, NC 27603-2526

Mailing address

1001 Rock Quarry Road
Raleigh, NC 27610
Phone (919) 833-3111

Other identifiers 1

IdentifierTypeStateIssuer
03095OtherNCBCBS

Other names 1

  • Advance Community Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040824000695 NC Part B Supplier - Clinic/Group Practice 3577471697 Receives reassigned benefits from 91 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wendell, NC; Wake Forest, NC; Raleigh, NC; Louisburg, NC; Apex, NC; Cary, NC; Holly Springs, NC; Fuquay Varina, NC

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1992979934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ROCK QUARRY ROAD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27610",
            "telephone_number": "919-833-3111",
            "fax_number": "919-250-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N WILMINGTON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276032526",
            "telephone_number": "919-250-2930",
            "fax_number": "919-573-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "PENELLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-250-2923"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "03095",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Community Health",
            "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 Jan 23, 2017; 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.