Organization
WAKE FOREST BAPTIST IMAGING, LLC
Active
Other names
Atrium Health Wake Forest Baptist Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
AMY STOUT (PRESIDENT/CEO)
(615) 261-2306
Entity
Organization
Contact information
Practice address
265 EXECUTIVE PARK BLVD, WINSTON SALEM, NC 27103-1503
(336) 765-5722
(336) 765-5723
Mailing address
800 CRESCENT CENTRE DR STE 400, FRANKLIN, TN 37067-7270
(615) 261-2306
(855) 588-3545
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5912396
—
NC
01
—
D06298
RAILROAD MEDICARE
NC
Enumeration date
06/10/2008
Last updated
12/16/2025
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