Wakemed Physician Practices Group Home

LBN: Wake Specialty Physicians Llc
Wakemed Physician Practices Group Home is an health care organization with primary practice located at 2820 Kidd Rd , Raleigh NC 27610-1842. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded. Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded is the primary health care specialty. Wake Specialty Physicians Llc can be contacted via phone (919) 350-2800, or through Jayoussi, Maria via phone (919) 350-6089.

Contact Information

Primary practice address
2820 Kidd Rd Raleigh NC 27610-1842
Phone: (919) 350-2800
Fax: (919) 350-8147
Website:
Map and Directions
Authorized official contact:
Name: Jayoussi, Maria
Phone: (919) 350-6089

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X North Carolina

Profile Details

NPI number 1497204143
LBN Legal business name Wake Specialty Physicians Llc
DBA Doing business as Wakemed Physician Practices Group Home
Authorized official Jayoussi, Maria
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 22nd, 2016
Last updated Mar 22nd, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497204143 NPPES
North Carolina MEDICAID 1942440375

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