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WAKEMED PHYSICIAN PRACTICES GROUP HOME
NPI 1497204143
Intermediate Care Facility, Intellectual Disabilities in Raleigh, NC

Active since September 22, 2016
2820 KIDD RD, RALEIGH, NC 27610(919) 350-2800(919) 350-8147 Get Directions Write a Review

NPPES record last updated: March 22, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 22, 2017, Feb 24, 2017, Feb 15, 2017 and 2 more (5 updates tracked since 2016).

About Wakemed Physician Practices Group Home NPPES

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

WAKEMED PHYSICIAN PRACTICES GROUP HOME (NPI 1497204143) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Raleigh, North Carolina and active in the NPI registry since September 2016. The organization lists Maria Jayoussi, Executive Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1497204143
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameWAKE SPECIALTY PHYSICIANS LLC
Location Address2820 KIDD RDRaleigh, NC 27610-1842
Mailing AddressPo Box 602195Charlotte, NC 28260-2195 · (919) 350-0552 · Fax (919) 350-7687
Phone(919) 350-2800
Fax(919) 350-8147
Organization SubpartYesParent: Wakemed
Authorized OfficialMaria JayoussiExecutive Director Of Finance · (919) 350-6089
Enumeration DateSeptember 22, 2016
Last NPPES UpdateMarch 22, 20175 updates tracked since enumeration
✔ NPI 1497204143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPediatricsTaxonomy 208000000X
2820 KIDD RD, Raleigh, NC 27610
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Other Names 1

Doing Business AsWakemed Physician Practices Group Home

Other Identifiers 2

Medicaid1942440375NC
Medicare PIN2347332NC

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

Other Providers at the Same Location NPPES 3

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

WAKEMED SPECIALISTS GROUP LLC
Intermediate Care Facility, Intellectual Disabilities
2820 KIDD RD
RALEIGH, NC 27610
Wake County (919) 350-2800
TASHIRA MONE HALL LPN
Licensed Practical Nurse
2820 KIDD RD
RALEIGH, NC 27610
Wake County (919) 231-8315
HILLTOP HOME INC.
Intermediate Care Facility, Intellectual Disabilities
2820 KIDD RD
RALEIGH, NC 27610
Wake County (919) 231-8315

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 Specialty Physicians LLC's NPI number?

The NPI number for Wake Specialty Physicians LLC is 1497204143. It was assigned to this organization in the NPPES registry on September 22, 2016. The provider is doing business as Wakemed Physician Practices Group Home.

Where is Wake Specialty Physicians LLC located?

Wake Specialty Physicians LLC is located at 2820 Kidd Rd, Raleigh, NC 27610. The listed phone number is (919) 350-2800.

What is Wake Specialty Physicians LLC's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Wake Specialty Physicians LLC was last updated on March 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.