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WAKEMED MYCARE 365 PRIMARY CARE & URGENT CARE
NPI 1699361618
Family Medicine in Zebulon, NC

Active since December 14, 2020CLIA 34D2216913 · Waiver
1260 N ARENDELL AVE, ZEBULON, NC 27597(919) 235-1965(919) 235-1326 Get Directions Write a Review

NPPES record last updated: January 5, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 5, 2022, Apr 22, 2021, Dec 15, 2020 (3 updates tracked since 2020).

About Wakemed Mycare 365 Primary Care & Urgent Care NPPES

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

WAKEMED MYCARE 365 PRIMARY CARE & URGENT CARE (NPI 1699361618) is a healthcare organization registered as a family medicine in Zebulon, North Carolina and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through March 16, 2027 and lists Shondra Lynn Brink, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1699361618
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWAKE SPECIALTY PHYSICIANS, LLC
Location Address1260 N ARENDELL AVEZebulon, NC 27597-8730
Mailing Address1260 N Arendell AveZebulon, NC 27597-8730 · (919) 235-1965 · Fax (919) 235-1326
Phone(919) 235-1965
Fax(919) 235-1326
Organization SubpartNo
Authorized OfficialShondra Lynn BrinkVp Of Operations · (919) 350-6045
Enumeration DateDecember 14, 2020
Last NPPES UpdateJanuary 5, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 5, 2022
✔ NPI 1699361618 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
1260 N ARENDELL AVE, Zebulon, NC 27597
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Other Names 1

Doing Business AsWakemed Mycare 365 Primary Care & Urgent Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE 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 34D2216913

Wakemed Mycare 365 Primary Care And Urgent Care - Zebulon · Zebulon, NC
Active · expires Mar 16, 2027
CLIA Number34D2216913
Laboratory TypePhysician Office
Certificate Effective DateMarch 17, 2025
Certificate Expiration DateMarch 16, 2027
Laboratory DirectorTheodore Scott Derse
Laboratory Phone(919) 350-7180
Laboratory LocationWakemed Mycare 365 Primary Care And Urgent Care - Zebulon1260 N Arendell Ave, Zebulon, NC 27597
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

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

VICTORIA GUMJUN GUTIERREZ DNP, FNP
Nurse Practitioner (Family)
1260 N ARENDELL AVE
ZEBULON, NC 27597
Wake County (919) 235-1965
SARAH MARGARET PETRIE
Student in an Organized Health Care Education/Training Program
1260 N ARENDELL AVE
ZEBULON, NC 27597
Wake County (919) 235-1965
DR. THEODORE SCOTT DERSE MD
Family Medicine
1260 N ARENDELL AVE
ZEBULON, NC 27597
Wake County (919) 235-1965
PAIGE FULLER LUCK PA-C
Physician Assistant
1260 N ARENDELL AVE
ZEBULON, NC 27597
Wake County (919) 235-1965
MATTHEW PAUL NORMAN
Physician Assistant
1260 N ARENDELL AVE
ZEBULON, NC 27597
Wake County (919) 235-1965
ELIZABETH WAMBUI KANIARU FNP-BC
Nurse Practitioner (Family)
1260 N ARENDELL AVE
ZEBULON, NC 27597
Wake County (919) 235-1965
JOEVELINO SABINO RAYMUNDO NP-C
Nurse Practitioner
1260 N ARENDELL AVE
ZEBULON, NC 27597
Wake County (919) 235-1326
DARRYL SANDIDGE PA
Physician Assistant
1260 N ARENDELL AVE
ZEBULON, NC 27597
Wake County (919) 235-1965

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 1699361618. It was assigned to this organization in the NPPES registry on December 14, 2020. The provider is doing business as Wakemed Mycare 365 Primary Care & Urgent Care.

Where is Wake Specialty Physicians, LLC located?

Wake Specialty Physicians, LLC is located at 1260 N Arendell Ave, Zebulon, NC 27597. The listed phone number is (919) 235-1965.

What is Wake Specialty Physicians, LLC's specialty?

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

Does Wake Specialty Physicians, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2216913) is associated with this NPI, valid through March 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wake Specialty Physicians, LLC accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC list Wake Specialty Physicians, LLC 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 Specialty Physicians, LLC was last updated on January 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.