Active NPI
Wesley William Carr, M.D.
- Sports Medicine (Family Medicine) Physician
- Fort Liberty, NC
National Provider Identifier
1124432430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 2016018274
- Practice address
- 2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-0001 - Phone
- (910) 907-8922
- Fax
- (910) 907-6069
- NPI assigned
- Jun 13, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2016018274 | MO | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 2016018274 | MO | Primary |
Addresses
Primary practice location
2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-0001
Mailing address
2817 Rock Merritt Ave Womack Army Medical Center
Fort Liberty, NC 28310-0001
Phone (910) 907-8922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151230000971 | MO | Order and Referring Only - Family Practice | 4981906419 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Saint Louis University School of Medicine, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11330 Olive Blvd
Suite 150
Creve Coeur, MO 63141-7149
1402 S Grand Blvd
M260
Saint Louis, MO 63104-1004
1402 S Grand Blvd
M260
Saint Louis, MO 63104-1078
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1124432430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
"city": "FORT LIBERTY",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
"city": "FORT LIBERTY",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "WESLEY",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-13",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2016018274",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "MO",
"license": "2016018274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Liberty, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.
- 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.