Individual provider Active NPI

Cheryl Durham Wheeler, APRN BC

  • Nurse Practitioner
  • Clyde, NC
National Provider Identifier
1154460715
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
34556 Issued in TN
Practice address
262 Leroy George Dr
Clyde, NC 28721-7430
Phone
(828) 452-8110
Fax
(828) 452-8318
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN037416 GA
Nurse Practitioner 363L00000X 34556 TN Primary

Addresses

Primary practice location

262 Leroy George Dr
Clyde, NC 28721-7430

Mailing address

615 Knoll Drive
Dalton, GA 30720
Phone (706) 226-7446

Other identifiers 1

IdentifierTypeStateIssuer
1154460715MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160705000858 WY Practitioner - Nurse Practitioner 6305872326
I20240513000340 TN Practitioner - Nurse Practitioner 6305872326 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
34556TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Mar 5, 2024 Accepting new patients
Hargrave Emergency Physicians LLC Nurse Practitioner Past Accepting new patients

Locations

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

304 Church St
Sweetwater, TN 37874
Phone (865) 213-8200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLC 776 clinicians

Practice addresses (Care Compare)

304 Church St
Sweetwater, TN 37874-1181
Phone (865) 213-8200

Hospital & facility affiliations

  • Sweetwater Hospital Association Hospital, Sweetwater, TN, CCN 440084

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1154460715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 KNOLL DRIVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-226-7446",
            "fax_number": "706-281-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 LEROY GEORGE DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287217430",
            "telephone_number": "828-452-8110",
            "fax_number": "828-452-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "CHERYL",
        "middle_name": "DURHAM",
        "name_prefix": "Ms.",
        "credential": "APRN BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN037416",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "34556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154460715",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.