Organization
WAKE RADIOLOGY CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER THOMAS (CREDENTIALING MANAGER)
(919) 788-7900
Entity
Organization
Contact information
Practice address
3949 BROWNING PL, RALEIGH, NC 27609-6536
(919) 787-8221
(919) 881-2079
Mailing address
PO BOX 19368, RALEIGH, NC 27619-9368
(919) 787-8221
(919) 789-4461
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8902888
—
NC
01
—
CC3793
RAILROAD MEDICARE
NC
Enumeration date
04/17/2006
Last updated
01/29/2026
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