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WAKE FOREST EMERGENCY PROVIDERS
NPI 1396216735
Clinic/Center - Multi-Specialty in Statesville, NC

Active since December 11, 2018
557 BROOKDALE DR, STATESVILLE, NC 28677(336) 716-2255 Get Directions Write a Review

NPPES record last updated: December 11, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Wake Forest Emergency Providers NPPES

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

WAKE FOREST EMERGENCY PROVIDERS (NPI 1396216735) is a healthcare organization registered as a multi-specialty in Statesville, North Carolina and active in the NPI registry since December 2018. The organization lists Chadwick D Miller, Chair Of Emergency Medicine, as its authorized official.

NPPES Registry Identity

NPI1396216735
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameWAKE FOREST EMERGENCY PROVIDERS
Location Address557 BROOKDALE DRStatesville, NC 28677-4100
Mailing AddressMedical Center BlvdWinston Salem, NC 27157-0001 · (336) 713-4944
Phone(336) 716-2255
Organization SubpartNo
Authorized OfficialChadwick D MillerChair Of Emergency Medicine · (336) 713-4944
Enumeration DateDecember 11, 2018
✔ NPI 1396216735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
557 BROOKDALE DR, Statesville, NC 28677
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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.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wake Forest Emergency Providers is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

576

Medicare enrollment records show 576 clinicians reassign Medicare billing to Wake Forest Emergency Providers, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Emergency Medicine503
Nurse Practitioner59
Pediatric Medicine6
Family Practice3
Internal Medicine2
Anesthesiology1
General Practice1
Osteopathic Manipulative Medicine1

Nearest to this location (20)

See all 576
Randy Carpenter, MD
Emergency Medicine
NPI 1629771241
557 BROOKDALE DR
Statesville, NC 28677
(330) 687-8025
✔ PECOS✔ Accepts MedicareSame address
Jonathan Torres
Emergency Medicine
NPI 1982090957
557 BROOKDALE DR
Statesville, NC 28677
(704) 437-0429
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Harpe, FNP-C
Nurse Practitioner
NPI 1881217776
708 HARTNESS RD
Statesville, NC 28677
(704) 402-1955
✔ PECOS✔ Accepts Medicare0.2 mi
Tina Kinney, FNP
Nurse Practitioner
NPI 1548529050
1540 E BROAD ST
Statesville, NC 28625
(704) 360-6500
✔ PECOS✔ Accepts Medicare1.2 mi
Angela Robertson-Turner, FNP
Nurse Practitioner
NPI 1619421088
653 BLUEFIELD RD STE A
Mooresville, NC 28117
(704) 360-6500
✔ PECOS✔ Accepts Medicare14 mi
Penney Parker, FNP-C
Nurse Practitioner
NPI 1831168855
653 BLUEFIELD RD STE A
Mooresville, NC 28117
(704) 360-6500
✔ PECOS✔ Accepts Medicare14 mi
Hannah Wyatt, NURSE PRACTITIONER
Nurse Practitioner
NPI 1619480738
1904 JAKE ALEXANDER BLVD W STE 301
Salisbury, NC 28147
(704) 638-1551
✔ PECOS✔ Accepts Medicare22 mi
William Fisher, MD
Emergency Medicine
NPI 1952380263
810 FAIRGROVE CHURCH RD
Hickory, NC 28602
(828) 326-3060
✔ PECOS✔ Accepts Medicare23 mi
Jon Giometti, MD
Emergency Medicine
NPI 1568405041
810 FAIRGROVE CHURCH RD
Hickory, NC 28602
(828) 326-3000
✔ PECOS✔ Accepts Medicare23 mi
Stephen Powell, M.D.
Emergency Medicine
NPI 1265842892
810 FAIRGROVE CHURCH RD
Hickory, NC 28602
(336) 716-2255
✔ PECOS✔ Accepts Medicare23 mi
Laura Brown, NURSE PRACTITIONER
Nurse Practitioner
NPI 1235666215
810 FAIRGROVE CHURCH RD
Hickory, NC 28602
(828) 732-7249
✔ PECOS✔ Accepts Medicare23 mi
Phoebe Glazer, MD
Emergency Medicine
NPI 1922539238
810 FAIRGROVE CHURCH RD
Hickory, NC 28602
(828) 326-3000
✔ PECOS✔ Accepts Medicare23 mi
Todd Pennell, FNP
Nurse Practitioner
NPI 1790738995
810 FAIRGROVE CHURCH RD
Hickory, NC 28602
(828) 326-3850
✔ PECOS✔ Accepts Medicare23 mi
Christopher Peluso, D.O.
Emergency Medicine
NPI 1104261593
810 FAIRGROVE CHURCH RD
Hickory, NC 28602
(828) 326-3000
✔ PECOS✔ Accepts Medicare23 mi
Mallory Patterson, MSN, RN, CPNP-AC
Nurse Practitioner
NPI 1528508793
129 WOODSON ST
Salisbury, NC 28144
(704) 636-5576
✔ PECOS24 mi
Yalonda Herndon, DO
Emergency Medicine
NPI 1215154331
16455 STATESVILLE RD
Huntersville, NC 28078
(704) 801-4000
✔ PECOS✔ Accepts Medicare25 mi
Brittany England, NP
Nurse Practitioner
NPI 1285100354
2874 NC HWY 127
Hickory, NC 28602
(828) 294-4100
✔ PECOS✔ Accepts Medicare25 mi
Tyler Loche, DO
Emergency Medicine
NPI 1023768926
433 MCALISTER RD
Lincolnton, NC 28092
(980) 212-2000
✔ PECOS✔ Accepts Medicare28 mi
Adebola Adekanmbi, MD
Internal Medicine
NPI 1609921212
271 EXECUTIVE PARK DR
Concord, NC 28025
(704) 721-4232
✔ PECOS✔ Accepts Medicare29 mi
Rebecca Raffler, DO
Pediatric Medicine
NPI 1265060941
1001 BLYTHE BLVD MEDICAL CENTER PLAZA SUITE 200
Charlotte, NC 28203
(704) 381-8840
✔ PECOS41 mi
See all 576 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wake Forest Emergency Providers's NPI number?

The NPI number for Wake Forest Emergency Providers is 1396216735. It was assigned to this organization in the NPPES registry on December 11, 2018.

Where is Wake Forest Emergency Providers located?

Wake Forest Emergency Providers is located at 557 Brookdale Dr, Statesville, NC 28677. The listed phone number is (336) 716-2255.

What is Wake Forest Emergency Providers's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Wake Forest Emergency Providers enrolled in Medicare?

Yes. Wake Forest Emergency Providers is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wake Forest Emergency Providers?

According to the CMS Revalidation Reassignment List (October 2026 release), 576 clinicians in 8 Medicare specialties reassign their Medicare billing to Wake Forest Emergency Providers. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Emergency Medicine (503), Nurse Practitioner (59) and Pediatric Medicine (6). Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Wake Forest Emergency Providers accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and Ambetter of Tennessee list Wake Forest Emergency Providers as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wake Forest Emergency Providers was last updated on December 11, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.