Douglas Alan Waldrep, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

2006-01911 Issued in NC

Practice address

2131 S 17TH St
Wilmington, NC 28401-7407

Phone

(910) 667-7000

Fax

(910) 815-5850

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Novant Health Medical Group Coastal Region, LLC

  dba NHMGCR Cape Fear Heart

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment NPD
• NMG Health Services LLC

  • Maternal & Fetal Medicine Physician
  • Bolivia, NC
  • NPI 1558242495
  NPD
• Novant Health Medical Group Coastal Region, LLC

  dba Nhmgcr Division of Psychiatry

  • Psychiatry Physician
  • Wilmington, NC
  • NPI 1881289932
  NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1164517751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-667-7000",
            "fax_number": "910-815-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDREP",
        "first_name": "DOUGLAS",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2006-01911",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "2006-01911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "2131 S 17th St",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwaldrep6978@direct.nhrmc.org",
            "affiliation": "N",
            "address_1": "2131 S 17th St",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wal-Mart Stores East, LP (Walmart Vision Center 30-4065)
• Wal-Mart Stores East, LP (Vision Center 30-1348)
• Wal-Mart Stores East, LP.
• Amy Ann Waldbillig, LCSW, PH.D.
• Harry Deak Walden, OPA-C
• Abigail Waldrop
• Walgreen Co (Walgreens #09931)
• Walgreen Co (Walgreens #01560)
• Walgreen Co (Walgreens #16174)
• Walgreen Co (Rite Aid)

• Child & Adolescent Psychiatry Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Child & Adolescent Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.