Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wake Forest Health Network LLC

Organization Pediatrics Physician · NPI 1063647394

Wake Forest Health Network LLC provides Pediatrics Physician services in Winston Salem, North Carolina. Registered with an NPI since 2009.

In the registry since
2009
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2933 Maplewood Ave
Winston Salem, NC 27103-4009
Phone: (336) 794-3380
Fax: (336) 794-3378
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1063647394
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Craig Greven — Sr Vp Clinical Operations · (336) 716-1331
Other names Atrium Health Wake Forest Baptist Pediatrics - Ford Simpson Lively & R
NPI enumeratedMay 15, 2009
Last updated in NPPESSeptember 25, 2025
Certification dateSeptember 25, 2025
Mailing address2933 Maplewood Ave Ste 1, Winston Salem, NC 27103-4001

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