Individual provider Active NPI

Hartwell Z Hildebrand, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1053404699
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36536 Issued in NC
Practice address
7810 Providence Rd
Suite 102
Charlotte, NC 28226-2954
Phone
(704) 543-6636
Fax
(704) 541-9476
NPI assigned
Oct 2, 2006
Last updated
Dec 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36536 NC Primary

Addresses

Primary practice location

7810 Providence Rd
Suite 102
Charlotte, NC 28226-2954

Mailing address

PO Box 60099
Charlotte, NC 28260-0099
Phone (704) 543-6636

Other identifiers 3

IdentifierTypeStateIssuer
40958MedicaidSC
1053404699MedicaidNC
89134HRMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36536NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Urgent Care LLC Family Medicine Past Accepting new patients
Cleveland Health Ventures LLC Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Union Urgent Care LLC Family Medicine Past Accepting new patients
Cabarrus Urgent Care Family Medicine Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1053404699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60099",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600099",
            "telephone_number": "704-543-6636",
            "fax_number": "704-541-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7810 PROVIDENCE RD",
            "address_2": "SUITE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282262954",
            "telephone_number": "704-543-6636",
            "fax_number": "704-541-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "HARTWELL",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "36536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40958",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053404699",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134HR",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.