Individual provider Active NPI

Elizabeth Oludayo Wilson-Durham, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1003932971
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008512 Issued in NC
Practice address
1237 Harding PL
Ste 3100
Charlotte, NC 28204
Phone
(704) 373-0212
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5008512 NC Primary
Nurse Practitioner 363L00000X 5008512 NC

Addresses

Primary practice location

1237 Harding PL
Ste 3100
Charlotte, NC 28204

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

447 McAlister Rd
Ste 3200
Lincolnton, NC 28092-4114
Phone (980) 212-6300

Other practice location 2

10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840

Other practice location 3

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255

Other practice location 4

1550 Faulk St
Ste 3100
Monroe, NC 28112-5086
Phone (704) 667-3410

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address ewilsondurham536659@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161103000853 NC Practitioner - Nurse Practitioner 7517034234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1001 Blythe Blvd
Suite 200D
Charlotte, NC 28203-6215
Phone (704) 373-1813

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11927TNMDDentist
5008512NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Oct 24, 2016 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 24, 2016 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 24, 2016 Accepting new patients
Carolinas Medical Center CurrentSince Oct 24, 2016 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients
T M Carr MD PC Nurse Practitioner Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1237 Harding Pl
Ste 4300
Charlotte, NC 28204

1237 Harding Pl
Ste 1300
Charlotte, NC 28204
Phone (704) 512-2401

1237 Harding Pl
#4400
Charlotte, NC 28204

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1001 Blythe Blvd
Ste 200D
Charlotte, NC 28203
Phone (704) 373-1813

1001 Blythe Blvd
Ste 300
Charlotte, NC 28203

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337

1237 Harding Pl
Unit 2100
Charlotte, NC 28204
Phone (704) 468-3055

990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272

447 McAlister Rd
Ste 3200
Lincolnton, NC 28092
Phone (980) 212-6300

1550 Faulk St
Ste 3100
Monroe, NC 28112
Phone (704) 667-3410

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: ewilsondurham536659@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1003932971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 HARDING PL",
            "address_2": "STE 3100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "447 McAlister Rd",
            "address_2": "STE 3200",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924114",
            "country_code": "US",
            "telephone_number": "980-212-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 Faulk St",
            "address_2": "Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281125086",
            "country_code": "US",
            "telephone_number": "704-667-3410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON-DURHAM",
        "first_name": "ELIZABETH",
        "middle_name": "OLUDAYO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008512",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewilsondurham536659@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.