Active NPI
Wedad Mohammed Khedr, M.D.
- Pediatrics Physician
- Fayetteville, NC
National Provider Identifier
1093750754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 202602758
- Practice address
- 1738 Owen Dr Ste 107
Fayetteville, NC 28304-3880 - Phone
- (910) 739-3318
- NPI assigned
- Jun 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036091500 | IL | |
| Pediatrics Physician | 208000000X | 202602758 | NC | Primary |
Addresses
Primary practice location
1738 Owen Dr Ste 107
Fayetteville, NC 28304-3880
Mailing address
PO Box 617
Somerton, AZ 85350-0617
Phone (928) 315-7910
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036091500 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 66835 | AZ | MD | Pediatrics Physician |
| 036091500 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787875200000",
"number": "1093750754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 617",
"city": "SOMERTON",
"state": "AZ",
"postal_code": "853500617",
"telephone_number": "928-315-7910",
"fax_number": "928-722-6113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1738 OWEN DR STE 107",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043880",
"telephone_number": "910-739-3318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHEDR",
"first_name": "WEDAD",
"middle_name": "MOHAMMED",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-18",
"last_updated": "2026-08-28",
"certification_date": "2026-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036091500",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "NC",
"license": "202602758",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036091500",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.