Active NPI
Harold Douglas Wackerle, M.D.
- Anesthesiology Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 2022-01839
- Practice address
- 3735 Glenlake Dr Ste 250
Charlotte, NC 28208-6866 - Phone
- (704) 749-5800
- Fax
- (704) 626-3237
- NPI assigned
- Apr 17, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2022-01839 | NC | Primary |
Addresses
Primary practice location
3735 Glenlake Dr Ste 250
Charlotte, NC 28208-6866
Mailing address
PO Box 117661
Atlanta, GA 30368-7661
Phone (704) 749-5800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- George Washington University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500
1800 E 4TH St
Charlotte, NC 28204-3210
Phone (704) 384-1300
1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000
1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4000
Hospital & facility affiliations
- Novant Health Presbyterian Medical Center
- Novant Health Matthews Medical Center
- Novant Health Ballantyne Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Anesthesiology Associates, P.a. | Anesthesiology | Current | Accepting new patients |
Locations
131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101
1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810
3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801
2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294
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.
-
- Anesthesiology Physician
- Charlotte, NC
- NPI 1659250678
SC
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1740998020
-
- General Acute Care Hospital
- Matthews, NC
- NPI 1063463156
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1396798591
Hospital
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1497708838
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1881647204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710201600000",
"number": "1205360260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 117661",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303687661",
"telephone_number": "704-749-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3735 GLENLAKE DR STE 250",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282086866",
"telephone_number": "704-749-5800",
"fax_number": "704-626-3237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WACKERLE",
"first_name": "HAROLD",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-17",
"last_updated": "2024-03-12",
"certification_date": "2024-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "2022-01839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.