Edward W Whitesides, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

36671 Issued in NC

Practice address

1905 Glen Meade Rd
Wilmington, NC 28403-6024

Phone

(910) 763-6251

Fax

(910) 763-7408

NPI assigned

Sep 13, 2005

Last updated

Dec 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: edwardwhitesides@uasnc.allscriptsdirect.net
• Direct secure messaging: ewhitesides1253183@direct.novanthealth.org

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

• Urology Associates of Southeastern North Carolina, PA

  • Urology Physician
  • Southport, NC
  • NPI 1689342263
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1033104344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036024",
            "telephone_number": "910-763-6251",
            "fax_number": "910-763-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036024",
            "telephone_number": "910-763-6251",
            "fax_number": "910-763-7408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11110 Medical Campus Rd Ste 228",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426727",
            "country_code": "US",
            "telephone_number": "301-733-0022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITESIDES",
        "first_name": "EDWARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "36671",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MD",
            "license": "D98830",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79-87180",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William James White
• Erin F. Whitehead, NP
• Lee A Whitehurst, M.D.
• Rasika Khatu Whitesell, O.D.
• Tyler C Whiteside, DPT
• Hanna Whitesides
• Alma Whitfield, LCSW
• Kimberly Lee Whitfield, LCMHC
• Diane Pittman Whitford, LPC
• Ashton Whitley

• Specialist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.