Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.
WAKE FOREST HEALTH NETWORK LLC
Complete NPI Record 1013437755
Internal Medicine in High Point, NC
Active since June 23, 2017CLIA 34D1077595 · Waiver
Complete NPI Dataset
This page contains the complete raw NPPES record for Wake Forest Health Network Llc (NPI 1013437755), an internal medicine organization in High Point, NC. All 35 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1013437755 Field 1/35
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/35
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/35
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: WAKE FOREST HEALTH NETWORK LLC Field 4/35
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: Not available Field 5/35
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 6 Field 6/35
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 1814 WESTCHESTER DR STE 203 Field 7/35
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: HIGH POINT Field 8/35
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: NC Field 9/35
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 272627369 Field 10/35
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/35
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 3368022489 Field 12/35
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 3368022026 Field 13/35
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 1814 WESTCHESTER DR STE 203 Field 14/35
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: HIGH POINT Field 15/35
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: NC Field 16/35
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 272627369 Field 17/35
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/35
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 3368022025 Field 19/35
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 3368022026 Field 20/35
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: GREVEN Field 23/35
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: CRAIG Field 24/35
- The first name of the authorized official.
- Authorized Official Middle Name: MICHAEL Field 25/35
- The middle name of the authorized official.
- Authorized Official Title or Position: SR VP CLINICAL OPERATIONS Field 26/35
- The title or position of the authorized official.
- Authorized Official Telephone Number: 3367161331 Field 27/35
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 207R00000X Field 28/35
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 29/35
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: Y Field 30/35
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Parent Organization LBN: CORNERSTONE HEALTH CARE, LLC Field 31/35
- The Legal Business Name (LBN) of the parent organization, if the provider is a subpart of a larger entity. This field identifies the official registered name of the parent company or organization under which the provider operates.
- Parent Organization TIN: Not available Field 32/35
- The Taxpayer Identification Number (TIN) of the parent organization, provided when the provider is a subpart of a larger entity. This field identifies the federal tax ID used by the parent organization for official and billing purposes.
- Authorized Official Credential Text: MD Field 33/35
- The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 34/35
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Other Organization Names 1
Additional business and trade names this provider has on file with the NPPES registry.
Atrium Health Wake Forest Baptist Complex Care - Westchester Doing Business As
Name 1/1Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Secondary Practice Locations 25
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
3369 Clingman Rd
Location 1/25Ronda, NC 28670-8708 · Phone (336) 984-3003 · Fax (336) 571-8602
911 E Atkins St Ste D
Location 2/25Dobson, NC 27017-8708 · Phone (336) 374-1010
680 Parkwood Medical Park
Location 3/25Elkin, NC 28621-2487 · Phone (336) 527-8359 · Fax (336) 571-8670
911 E Atkins St
Location 4/25Dobson, NC 27017-8708 · Phone (336) 374-1113 · Fax (336) 571-8613
150 Chatham Medical Park
Location 5/25Elkin, NC 28621-2445 · Phone (336) 258-8100 · Fax (336) 258-8095
5229 Rock Creek Rd
Location 6/25Hays, NC 28635-9267 · Phone (336) 696-2711 · Fax (336) 571-8603
2909 Horse Pen Creek Rd
Location 7/25Greensboro, NC 27410-9701 · Phone (336) 716-0077 · Fax (336) 702-0596
546 Winston Rd
Location 8/25Jonesville, NC 28642-2217 · Phone (336) 526-2377 · Fax (336) 571-8615
2909 Horse Pen Creek Rd Ste 100
Location 9/25Greensboro, NC 27410-9701 · Phone (336) 716-6099
800 Chatham Medical Park
Location 10/25Elkin, NC 28621-2484 · Phone (336) 835-7676 · Fax (336) 571-8665
101 Eldon Parks Dr Ste A
Location 11/25Elkin, NC 28621-2459 · Phone (336) 835-2349 · Fax (336) 571-8671
631 Cc Camp Rd
Location 12/25Elkin, NC 28621-8705 · Phone (336) 366-1072 · Fax (336) 571-8648
150 Parkwood Dr
Location 13/25Elkin, NC 28621-2430 · Phone (336) 527-7463 · Fax (336) 571-8601
201 W Main St
Location 14/25Elkin, NC 28621-3490 · Phone (336) 526-6195 · Fax (336) 571-8606
180 Parkwood Dr
Location 15/25Elkin, NC 28621-2430 · Phone (336) 527-7298 · Fax (336) 571-8669
233 Doctors St
Location 16/25Sparta, NC 28675-9247 · Phone (336) 372-5511 · Fax (336) 372-8451
600 Chatham Medical Park
Location 17/25Elkin, NC 28621-2482 · Phone (336) 835-4819 · Fax (336) 571-8608
400 Johnson Ridge Medical Park
Location 18/25Elkin, NC 28621-2447 · Phone (336) 526-4500
300 Johnson Ridge Medical Park
Location 19/25Elkin, NC 28621-2453 · Phone (336) 258-8094
201A Eldon Parks Dr
Location 20/25Elkin, NC 28621-2461 · Phone (336) 527-7463
690 Parkwood Medical Park
Location 21/25Elkin, NC 28621-2487 · Phone (336) 526-2619 · Fax (333) 651-8628
500 Chatham Medical Park
Location 22/25Elkin, NC 28621-2481 · Phone (336) 527-7002 · Fax (336) 571-8609
200 Johnson Ridge Medical Park
Location 23/25Elkin, NC 28621-2443 · Phone (336) 526-0040 · Fax (336) 571-8605
1030 Mall Loop Rd
Location 24/25High Point, NC 27262-7656 · Phone (336) 781-4320 · Fax (336) 781-4321
101 Eldon Parks Dr Ste B
Location 25/25Elkin, NC 28621-2459 · Phone (336) 526-0188 · Fax (336) 571-8647
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