WAKEMED PRIMARY CARE KNIGHTDALE - NPI 1225449168 - Family Medicine in Knightdale, NC

Q: What is Wake Specialty Physicians LLC's NPI number?

The NPI number for Wake Specialty Physicians LLC is 1225449168. It was assigned to this organization in the NPPES registry on May 14, 2014. The provider is doing business as Wakemed Primary Care Knightdale.

Q: What is Wake Specialty Physicians LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Wakemed Primary Care Knightdale NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WAKEMED PRIMARY CARE KNIGHTDALE (NPI 1225449168) is a healthcare organization registered as a family medicine in Knightdale, North Carolina and active in the NPI registry since May 2014. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists Maria Jayoussi, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1225449168

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameWAKE SPECIALTY PHYSICIANS LLC

Location Address901 OLD KNIGHT RDKnightdale, NC 27545-9065

Mailing AddressPo Box 602195Charlotte, NC 28260-2195 · (919) 350-0554

Phone(919) 266-6211

Fax(919) 350-9824

Organization SubpartNo

Authorized OfficialMaria JayoussiExecutive Director Of Finance · (919) 350-6089

Enumeration DateMay 14, 2014

Last NPPES UpdateAugust 8, 20193 updates tracked since enumeration

✔ NPI 1225449168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedInternal MedicineTaxonomy 207R00000X

901 OLD KNIGHT RD, Knightdale, NC 27545

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Other Names 1

Doing Business AsWakemed Primary Care Knightdale

Other Identifiers 1

Medicaid1225449168NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0891271

Wakemed Primary Care - Knightdale · Knightdale, NC

Active · expires Jan 30, 2027

CLIA Number34D0891271

Laboratory TypePhysician Office

Certificate Effective DateJanuary 31, 2025

Certificate Expiration DateJanuary 30, 2027

Laboratory DirectorJennifer Phifer

Laboratory Phone(919) 350-7180

Laboratory LocationWakemed Primary Care - Knightdale901 Old Knight Road, Knightdale, NC 27545

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MINTORIA LYNETTE STOCKTON APRN, FNP-C

Nurse Practitioner (Family)