Provider Demographics
NPI:1972579837
Name:WAKEMED
Entity type:Organization
Organization Name:WAKEMED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP, FINANCE & CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SESSOMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-350-0522
Mailing Address - Street 1:3000 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1295
Mailing Address - Country:US
Mailing Address - Phone:919-350-8000
Mailing Address - Fax:
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1295
Practice Address - Country:US
Practice Address - Phone:919-350-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAKEMED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-28
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
275N00000X
NCH0199282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00356OtherBLUE CROSS
NC3400069AMedicaid
NC009OtherCHAMPUS
NC3400069Medicaid
NY3400069FMedicaid
NC011OtherCHAMPUS
NC003OtherCHAMPUS
NC00361OtherBLUE CROSS
NC3400069EMedicaid
NC002C9OtherBCBS PROVIDER NUMBER
NC=========0004OtherCOMMERCIAL
NC=========0002OtherCOMMERCIAL
NY3400069FMedicaid
NC3400069Medicaid
NC00361OtherBLUE CROSS