Individual provider Active NPI

Michael Wayne Klinkner, M.D.

  • Family Medicine Physician
  • Cary, NC
National Provider Identifier
1184675423
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34652 Issued in NC
Practice address
110 Kildaire Park Dr
Cary, NC 27518-8162
Phone
(919) 859-1136
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34652 NC Primary

Addresses

Primary practice location

110 Kildaire Park Dr
Cary, NC 27518-8162

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0351

Other identifiers 3

IdentifierTypeStateIssuer
1184675423MedicaidNC
49646OtherNCBCBS
8911495MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mklinkner98396@directHISP.wakemed.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050308000945 NC Practitioner - Family Practice 6800840323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

2406 Blue Ridge Rd
Raleigh, NC 27607-6678
Phone (919) 789-4322

Hospital & facility affiliations

  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34652NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Physicians, LLC Family Medicine Current Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Aug 22, 2019 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Dec 7, 2015 Accepting new patients
Wake Specialty Physicians, LLC CurrentSince Dec 7, 2015 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Cumberland County Hospital System Inc Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
United Emergency Services, Inc. Past Accepting new patients

Locations

212 Ashville Ave
Cary, NC 27518
Phone (919) 859-1136

110 Kildaire Park Dr
Cary, NC 27518
Phone (919) 235-0616

222 Ashville Ave
Cary, NC 27518
Phone (919) 576-2330

800 Tilghman Dr
Dunn, NC 28334
Phone (910) 230-7800

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

2920 Highwoods Blvd
Raleigh, NC 27604

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

2406 Blue Ridge Rd
Raleigh, NC 27607
Phone (919) 539-3796

Interoperability endpoints

  • Direct secure messaging: mklinkner98396@directhisp.wakemed.org

Organizations & group practices 9

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184675423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 KILDAIRE PARK DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188162",
            "telephone_number": "919-859-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKNER",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-03-07",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "34652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184675423",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "49646",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911495",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mklinkner98396@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "222 Ashville Ave",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275186130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.