Provider Demographics
NPI:1053488346
Name:WAKEMED
Entity Type:Organization
Organization Name:WAKEMED
Other - Org Name:WAKEMED HEALTH AND HOSPITALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE, INTERIM CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:THOMPSON
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:27610-1231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1807
Practice Address - Country:US
Practice Address - Phone:919-350-6436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAKEMED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-29
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0920838341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406795Medicaid
NC340069Medicare ID - Type Unspecified