Organization Active NPI

Wilmington Fertility Center PLLC

  • Reproductive Endocrinology Physician
  • Wilmington, NC
National Provider Identifier
1114648391
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
Legal business name
WILMINGTON FERTILITY CENTER PLLC
Practice address
5815 Oleander Dr
Suite 240
Wilmington, NC 28403
Phone
(910) 444-1980
NPI assigned
Sep 7, 2022
Last updated
Sep 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Daniel Shanahan, CFO
Title
Chief Financial Officer
Phone
(781) 434-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VE0102X Primary

Addresses

Primary practice location

5815 Oleander Dr
Suite 240
Wilmington, NC 28403

Mailing address

5815 Oleander Dr
Suite 240
Wilmington, NC 28403
Phone (910) 444-1980

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2270076Wilmington Fertility Center PLLC5815 Oleander Dr Suite 240, Wilmington, NC 28403AccreditationMar 26, 2028

National Provider Directory

National Provider Directory

Locations

5815 Oleander Dr
Ste 240
Wilmington, NC 28403
Phone (910) 444-1980

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1114648391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 OLEANDER DR",
            "address_2": "SUITE 240",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28403",
            "telephone_number": "910-444-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 OLEANDER DR",
            "address_2": "SUITE 240",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28403",
            "telephone_number": "910-444-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMINGTON FERTILITY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "SHANAHAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "781-434-6500",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.