Individual provider Active NPI

Eugene Y Wang, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1053768739
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019-02121 Issued in NC
Practice address
3149 Freedom Dr
Charlotte, NC 28208-3869
Phone
(980) 302-9405
Fax
(980) 302-9406
NPI assigned
May 23, 2016
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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 2019-02121 NC Primary

Addresses

Primary practice location

3149 Freedom Dr
Charlotte, NC 28208-3869

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (980) 302-9000

Other practice location 1

19485 Old Jetton Road
Novant Health Family Medicine Residency Clinic
Cornelius, NC 28031
Phone (704) 316-5170

Other practice location 2

19485 Old Jetton Road
Novant Health Family Medicine Residency Clinic
Cornelius, NC 28031
Phone (704) 316-5170

Other practice location 3

2225 Freedom Dr
Charlotte, NC 28208
Phone (980) 302-9000

Other practice location 4

2225 Freedom Dr
Charlotte, NC 28208
Phone (980) 302-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ewang331662@direct.novanthealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191106002760 NC Practitioner - Family Practice 0244512929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

2225 Freedom Dr
Charlotte, NC 28208-1000
Phone (704) 384-7390

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Jul 17, 2019 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 17, 2019 Accepting new patients
NH Digital Health Services, LLC CurrentSince Sep 1, 2020 Accepting new patients
NH Digital Health Services, LLC Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Mar 24, 2024 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

2225 Freedom Dr
Charlotte, NC 28208
Phone (704) 316-5166

3149 Freedom Dr
Charlotte, NC 28208
Phone (980) 302-9405

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2085 Frontis Plaza Blvd
Winston Salem, NC 27103
Phone (336) 277-7226

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1053768739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "980-302-9000",
            "fax_number": "980-302-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3149 FREEDOM DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083869",
            "telephone_number": "980-302-9405",
            "fax_number": "980-302-9406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19485 Old Jetton Road",
            "address_2": "Novant Health Family Medicine Residency Clinic",
            "address_purpose": "LOCATION",
            "city": "Cornelius",
            "state": "NC",
            "postal_code": "28031",
            "country_code": "US",
            "telephone_number": "704-316-5170",
            "fax_number": "704-384-1776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19485 Old Jetton Road",
            "address_2": "Novant Health Family Medicine Residency Clinic",
            "address_purpose": "LOCATION",
            "city": "Cornelius",
            "state": "NC",
            "postal_code": "28031",
            "country_code": "US",
            "telephone_number": "704-316-5170",
            "fax_number": "704-384-1776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2225 Freedom Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28208",
            "country_code": "US",
            "telephone_number": "980-302-9000",
            "fax_number": "980-302-9025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2225 Freedom Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28208",
            "country_code": "US",
            "telephone_number": "980-302-9000",
            "fax_number": "980-302-9025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "EUGENE",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-02121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewang331662@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "19485 Old Jetton Road",
            "address_2": "Novant Health Family Medicine Residency Clinic",
            "city": "Cornelius",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.