HVS New Provider

Use this form to add a provider to an existing practice. If your practice is not already a WKCC High Value Specialist participant, please fill out the practice inquiry form.

National Provider Identifier
If yes we will reach out to acquire additional locations.
Click or drag a file to this area to upload.
Users are advised that the information submitted through this form may be transmitted over unsecured email and releases WakeMed and its employees, agents, and subcontractors from all responsibility or liability for any claims or damages arising from the content of the Email Form or the transmission thereof. By selecting the "I agree to Terms and Conditions" checkbox user acknowledges these terms and conditions and consents to transmission of the form. Plus, by completing this form, I am agreeing to receive relevant health information from WakeMed. I understand I can opt-out from these communications at any time.
Portal Access