# WAKEMED SPECIALISTS GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WakeMed - Virtual Cardiac Rehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063304228
- **Authorized official:** KAREN REVICKI PERRY (SERVICE LINE EXECUTIVE DIRECTOR)
- **Authorized official phone:** (919) 350-8000

## Contact information

- **Practice address:** 3000 NEW BERN AVE, RALEIGH, NC 27610-1231
- **Practice address phone:** (919) 350-8000
- **Mailing address:** PO BOX 603949, CHARLOTTE, NC 28260-3949
- **Mailing address phone:** (919) 350-0554
- **Mailing address fax:** (919) 350-0554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC3500X | Cardiac Rehabilitation Registered Nurse | — | NULL | Yes |
| 163WC3500X | Cardiac Rehabilitation Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2025
- **Last updated:** 07/21/2025